Talk:Eye movement desensitization and reprocessing

Reference review and related undue weight discussion

If you (other Wikipedians) are willing, I offer this proposal:

(1) Post references from relevant reliable sources, primarily systematic reviews or other authoritative texts (such as professional guidelines), that have been published in the past dozen years or so, but which are not currently referenced in the EMDR article; and if you wish, include the abstract, conclusion, or a pithy quote from the source that helps others understand that article's focus;

(2) comment on references currently cited in the Wikipedia EMDR article that (you believe) receive undue weight or selective emphasis;

(3) It might prove helpful for all of us to take some time (on our own) to "argue for the other side" (just thinking about it or even writing down reasons that support the opposing viewpoint), an exercise that sometimes enhances understanding, reduces tension, and helps a group move closer to consensus.

→ Please post comments, replies, and other contributions in the appropriate subsection. These are the subsections I set up for this discussion:

Time frame for this discussion – Self-explanatory.

Especially important policy specifics – Please add what you consider to be especially important Wikipedia policy specifics that should guide this discussion and (hopefully) move us closer to a consensus.

New references – This is the section where you can add references (reliable sources) published in the past dozen years or so, which are not currently referenced in the EMDR article. Create a subheading for the references you add, like the one I created.

References added by Markworthen – This is the subsection I created for the new references I have added (so far).

References given undue weight (too much or not enough), or overemphasizing one aspect while ignoring other findings – This is the subsection where you can highlight references currently cited in the EMDR article that (in your opinion) receive undue weight or which emphasize a specific finding in a systematic review, while neglecting to mention other equally important findings (in the same systematic review article). I posted one such article (in the References given undue weight subsection) that serves as a good example of what should go in this subsection.

→ If you believe this topic (Reference review and related undue weight discussion) could be organized more effectively, please feel free to make the changes you believe would enhance understanding and facilitate a more fruitful discussion.

Time frame for this discussion

I will work hard to regularly contribute to this discussion, but I cannot devote more than two or three hours per week to this effort. To accommodate the needs of editors with relatively less time to devote to Wikipedia, I ask that we allow this discussion to unfold over several weeks, as opposed to expecting to achieve a consensus (or lack thereof) within a week or two. This means, if you are willing, avoiding any conclusive statements for at least six weeks (if you would be so kind). (Note: By "conclusive" I mean "so irrefutable as to end all uncertainty or question" (Merriam-Webster Unabridged at synonym discussion).

Especially important policy specifics

In this section, please add especially important Wikipedia policy specifics that (in your opinion) should guide this discussion. I put mine immediately below. Please add yours below the sentence that begins with: → Please highlight other aspects.

The guiding policy for this discussion is WP:NPOV: "All encyclopedic content on Wikipedia must be written from a neutral point of view (NPOV), which means representing fairly, proportionately, and, as far as possible, without editorial bias, all the significant views that have been published by reliable sources on a topic."

And, within WP:NPOV, I believe the WP:YESPOV section is especially important: "Achieving what the Wikipedia community understands as neutrality means carefully and critically analyzing a variety of reliable sources and then attempting to convey to the reader the information contained in them fairly, proportionately, and as far as possible without editorial bias. Wikipedia aims to describe disputes, but not engage in them. The aim is to inform, not influence. Editors, while naturally having their own points of view, should strive in good faith to provide complete information and not to promote one particular point of view over another. As such, the neutral point of view does not mean the exclusion of certain points of view; rather, it means including all verifiable points of view which have sufficient due weight. Observe the following principles to help achieve the level of neutrality that is appropriate for an encyclopedia: Avoid stating opinions as facts. ... Prefer nonjudgmental language. ... Indicate the relative prominence of opposing views."

→ Please highlight other aspects of WP:NPOV or related policies you believe we should keep in mind.

New references

Note: "New" means published in the past dozen years or so, but which are not currently referenced in the EMDR article. Also see the subsection (below), References given undue weight (too much or not enough, or overemphasizing one aspect while ignoring other findings.

References added by Markworthen

The following references are from the first page or two of results on PubMed searching for EMDR (all fields), 2011–2025, systematic reviews. I will review additional results from that search later this week.

Lewis C, Roberts NP, Andrew M, Starling E, Bisson JI. Psychological therapies for post-traumatic stress disorder in adults: systematic review and meta-analysis. Eur J Psychotraumatol. 2020;11(1):1729633. Published 2020 Mar 10. doi:10.1080/20008198.2020.1729633

Conclusions: A recent increase in RCTs of psychological therapies for PTSD, results in a more confident recommendation of CBT-T and EMDR as the first-line treatments. Among the CBT-Ts considered by the review CPT, CT and PE should be the treatments of choice. The findings should guide evidence informed shared decision-making between patient and clinician.

{COMMENT: Note that these authors classify EMDR as a separate type of therapy from the "CBT-T's" (CBT with a trauma focus)}

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O'Doherty L, Whelan M, Carter GJ, et al. Psychosocial interventions for survivors of rape and sexual assault experienced during adulthood. Cochrane Database Syst Rev. 2023;10(10):CD013456. Published 2023 Oct 5. doi:10.1002/14651858.CD013456.pub2

Our review consolidates evidence on mainstay treatments for PTSD, supporting the continued use of trauma-focused psychotherapies such as EMDR, Cognitive Processing Therapy and Prolonged Exposure as first-line treatments for PTSD. (p. 30)

{COMMENT: Thus, this Cochrane review concludes that EMDR is a first-line treatment for PTSD that developed after rape or sexual assault experienced during adulthood.}

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Valiente-Gómez A, Moreno-Alcázar A, Treen D, et al. EMDR beyond PTSD: A Systematic Literature Review. Front Psychol. 2017;8:1668. Published 2017 Sep 26. doi:10.3389/fpsyg.2017.01668

Abstract: Background: Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD) through several randomized controlled trials (RCT). Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain. Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions. Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement. Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions.

{COMMENT: Note that the authors emphasize the tentative nature of the evidence, e.g., "EMDR might be useful" (emphasis added). I don't know that we should necessarily cite this article, but if we do, we should emphasize that these findings are tentative. I think this is particularly important given the tendency of some EMDR practitioners to believe (and market) EMDR as a cure-all, e.g., "it can be used to treat almost any mental disorder!" I stress this point not to argue for editorializing in a Wikipedia article, but to argue for stating in Wikipedia voice that strong evidence does not exist at this time demonstrating that EMDR is an effective therapy for non-trauma mental disorders. (Note: There might be evidence out there that I have not seen yet, which shows that EMDR is an effective intervention for a specific non-trauma mental disorder.)}

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Gillies D, Maiocchi L, Bhandari AP, Taylor F, Gray C, O'Brien L. Psychological therapies for children and adolescents exposed to trauma. Cochrane Database Syst Rev. 2016;10(10):CD012371. Published 2016 Oct 11. doi:10.1002/14651858.CD012371

For reduction of PTSD symptoms in the short term, there was a small effect favouring CBT over EMDR, play therapy and supportive therapies (SMD -0.24, 95% CI -0.42 to -0.05; 7 studies; 466 participants). The quality of evidence for this outcome was rated as moderate. ... Authors' conclusions: The meta-analyses in this review provide some evidence for the effectiveness of psychological therapies in prevention of PTSD and reduction of symptoms in children and adolescents exposed to trauma for up to a month. However, our confidence in these findings is limited by the quality of the included studies and by substantial heterogeneity between studies. Much more evidence is needed to demonstrate the relative effectiveness of different psychological therapies for children exposed to trauma, particularly over the longer term. High-quality studies should be conducted to compare these therapies.

{COMMENT: Thus, for reduction of PTSD symptoms in the short term, there was "a small effect favouring CBT over EMDR, play therapy and supportive therapies." However: "Much more evidence is needed to demonstrate the relative effectiveness of different psychological therapies ..." so I think we should succinctly summarize the conclusions of this Cochrane review when discussing EMDR with children, but I would be hesitant to also cite this Cochrane review in a general statement about comparative effectiveness of trauma-focused CBT vs. EMDR because lumping together adult and pediatric research is, to some extent, comparing apples to oranges, and it would be giving undue weight to a finding wherein the authors emphasize that "much more evidence is needed."}

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Scelles C, Bulnes LC. EMDR as Treatment Option for Conditions Other Than PTSD: A Systematic Review. Front Psychol. 2021;12:644369. Published 2021 Sep 20. doi:10.3389/fpsyg.2021.644369

Eye Movement Desensitisation and Reprocessing (EMDR) is a treatment for post-traumatic stress disorder (PTSD). The technique is known to facilitate reprocessing of maladaptive memories that are thought to be central to this pathology. Here we investigate if EMDR therapy can be used in other conditions. ... Despite a generally positive outlook of EMDR as an alternative treatment option, more methodologically rigorous studies are needed. We discuss the advantages and limitations and possible implications for the hypothesised mechanisms of action.

{COMMENT: I believe we should cite this article because it emphasizes that the current evidence base for EMDR as a treatment for conditions other than PTSD is not sufficient to recommend it as a firstline treatment for other mental disorders when trauma is not an etiological factor. (I acknowledge that is my conclusive language based on my reading of the literature on this topic, so we would need to phrase it more precisely in the article.)}

References given undue weight (too much or not enough), or overemphasizing one aspect while ignoring other findings

For example, consider the following quote from an explanatory essay, titled, Wikipedia:Reliable sources and undue weight: "Undue weight applies to more than just viewpoints. Just as giving undue weight to a viewpoint is not neutral, so is giving undue weight to other verifiable and sourced statements. An article should not give undue weight to any aspects of the subject, but should strive to treat each aspect with a weight appropriate to its significance to the subject. Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements."

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Cusack K, Jonas DE, Forneris CA, et al. Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clin Psychol Rev. 2016;43:128-141. doi:10.1016/j.cpr.2015.10.003 {COMMENT: Selective conclusions are drawn from the article while ignoring other more positive conclusions and recommendations about EMDR.}

Quotes from article:

Evidence supports the efficacy of EMDR for reduction of PTSD symptoms, but SOE is low because of some inconsistency and imprecision. {COMMENT: The preceding point is emphasized in the Wikipedia EMDR article.} Evidence supports the efficacy of EMDR for achieving loss of PTSD diagnosis and improving depression symptoms (moderate SOE for both); {COMMENT: The preceding finding is ignored in the Wikipedia EMDR article} ... Discussion: However, other factors must be considered in selecting a treatment for PTSD, including patient preference, access to treatment, and clinical judgment about the appropriateness of an intervention. For instance, exposure therapy and CPT are now readily available in most VAMC outpatient settings, but are less likely to be available in community-based mental health centers. A majority of the studies we reviewed excluded patients with substance dependence or suicidality. Most clinicians would agree that stabilization of suicidality and, at a minimum, detoxification from substances should occur prior to initiating a trauma-focused psychotherapy such as exposure therapy. There is less consensus on whether substance use disorder therapy should be integrated with PTSD therapy or conducted prior to or concomitantly with PTSD25 therapy, although emerging research shows promise for integrated therapies (Mills,et al., 2012; Sannibale, et al., 2013). Given the magnitude of benefit and SOE for cognitive therapy (including CPT), CBT-mixed, NET, and EMDR, we recommend that these therapies should also be considered based on the above considerations. {COMMENT: The preceding quote from the Discussion section is ignored in the Wikipedia EMDR article; emphasis added - italicised text.}

-- Mark D Worthen PsyD (talk) [he/him] 17:05, 22 January 2025 (UTC)

This is a WP:WALLOFTEXT which is quite difficult to parse.

Evidence supports the efficacy of EMDR for achieving loss of PTSD diagnosis and improving depression symptoms (moderate SOE for both); {COMMENT: The preceding finding is ignored in the Wikipedia EMDR article

On this point, though. Worth saying that we on Wikipedia SUMMARIZE. We do not simply repeat or re-host systematic reviews and meta-analyses. — Shibbolethink ^{(♔ ♕)} 20:49, 31 January 2025 (UTC)

I did not mean that we should include everything I wrote in the Wikipedia article. I'm sorry I did not make that point clear. Mark D Worthen PsyD (talk) [he/him] 04:22, 1 February 2025 (UTC)

I am not suggesting that everything I wrote should be included in the Wikipedia article. I was trying to include enough information for you to understand my point without having to read the entire research article. -- Mark D Worthen PsyD (talk)

The coverage of this article is inadequate

I added a comment here, which, despite my request that it not be censored, was abruptly removed without discussion by JoJo Anthrax. The comment was as follows:

The coverage of this article is inadequate. The problem is not confined to just this acticle, but is becoming increasingly widespread on Wikipedia. If Wikipedia is to retain (and perhaps recover) credibility, it needs to start gearing up for a reexamination of how it selects sources, and how the reliability of those sources is presented.

The original discussions nearly two decades ago on verification, were ground breaking and established the key Wikipedia policy. Briefly, the policy means that on Wikipedia, the focus is not to directly ask whether something is true, but to establish whether it can be verified. Verification means that what is present in Wikipedia should be supported with "reliable sources" (mainly scientific article reviews and mainstream media).

But things have moved on with the decades. In the West, mainstream media (and even to some extent scientific publishing houses) have been captured and distorted by ideological claptrap. Wikipedia increasingly creaks from growing failures to present information acceptably and cope with a changing world. Establishing what is "true", or "acceptably true", is becoming increasingly problematic. The relation between what is on Wikipedia and what is acceptable truth needs reassessment, and might take some years. Perhaps Wikipedia could go global and appeal for constructive input from users on, say, X and BlueSky. Policies may need modifying to reflect better operational criteria, unless in the meantime the established media cleans up its act. AI is beginning to grow muscle, and can both assist with resolving this issue (as well as presenting addition difficulties).

Please do not censor this comment, by deleting or hatting it. — Epipelagic (talk) 07:58, 26 January 2025 (UTC)

Wikipedia has categorised this article as pseudoscience. There is a large section titled "Pseudoscience" which uses only dated sources from 10 and more years ago. If Wikipedia is getting this wrong, then it is a serious matter which could be inhibiting acceptance of the area and of legitimate scientific inquiry.

DeepSeek, centre of the current AI imbroglio, can provide a wider perspective here, since it provides a distillation of what a number of the top current AI machines are thinking. When asked: "Is EMDR a pseudoscience?", it replied...

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No, Eye Movement Desensitization and Reprocessing (EMDR) is not considered pseudoscience. It is a well-researched and evidence-based psychotherapy approach, particularly for treating post-traumatic stress disorder (PTSD) and other trauma-related conditions. EMDR has been endorsed by numerous reputable organizations, including:

• The World Health Organization (WHO)

• The American Psychological Association (APA)

• The U.S. Department of Veterans Affairs (VA)

• The International Society for Traumatic Stress Studies (ISTSS)

How EMDR Works

EMDR involves a structured eight-phase approach that helps individuals process traumatic memories and reduce their emotional impact. A key component of EMDR is bilateral stimulation, which typically involves the therapist guiding the patient to move their eyes back and forth (following the therapist's fingers) while recalling traumatic memories. Other forms of bilateral stimulation, such as tapping or auditory tones, can also be used.

The goal is to help the brain reprocess traumatic memories, making them less distressing and integrating them into the individual's broader memory network.

Evidence for EMDR

• Effectiveness for PTSD: Numerous studies have shown that EMDR is effective in reducing symptoms of PTSD, often with results comparable to or better than other evidence-based treatments like Cognitive Behavioral Therapy (CBT).

• Mechanisms of Action: While the exact mechanisms of EMDR are still being studied, research suggests that the bilateral stimulation component may help activate the brain's natural information-processing systems, facilitating the resolution of traumatic memories.

• Broad Applications: EMDR has also been used to treat other conditions, such as anxiety, depression, phobias, and chronic pain, though the evidence is strongest for its use in trauma-related disorders.

Criticisms and Controversies

While EMDR is widely accepted, it is not without criticism:

• Eye Movements: Some researchers question whether the eye movements themselves are necessary or if the therapeutic benefits come from other aspects of the treatment, such as exposure to traumatic memories or the therapeutic relationship.

• Theoretical Basis: The theoretical explanation for why EMDR works is still debated, and some argue that it overlaps significantly with established principles of exposure therapy.

Conclusion

EMDR is not pseudoscience; it is a legitimate and empirically supported treatment for trauma-related conditions. However, like any therapy, its effectiveness can vary depending on the individual and the skill of the therapist. If you're considering EMDR, it's important to work with a trained and licensed mental health professional who specializes in this approach.

AI-generated, for reference only

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So Wikipedia is seriously out of step with assessments by current AI.

Anyone with an ability to assess what is available on Google Scholar will find that, over the past decade, EMDR has built a solid science track record. So, in this case, Wikipedia is also out of step with Google Scholar and the scientific community.

If articles like this one are not going to be treated with more awareness and sensitivity by their legacy gatekeepers, then Wikipedia is going to decline into disrepute. As one of the main content builders on Wikipedia, I find that dismaying. — Epipelagic (talk) 02:49, 30 January 2025 (UTC)

We don't rely on large language AI models as a source. Zenomonoz (talk) 10:08, 30 January 2025 (UTC)

Where did I suggest you should? — Epipelagic (talk) 10:16, 30 January 2025 (UTC)

Please don't waste people's time by pasting AI-generated blather onto talk pages. It is utterly unusable and will not convince anyone. MrOllie (talk) 16:58, 30 January 2025 (UTC)

MrOllie is, of course, entirely entitled to his position. Though he hasn't established whether his position is any more grounded than the Wikipedia article. To recapitulate, The Wikipedia position in this article is seriously out of step with a distillation of assessments by current AI. A casual examination of scientific findings over the past decade using Google Scholar seems to confirm this. Can people here bring a fresh objective approach to the issue, and establish whether the AI position is, or is not, essentially accurate? — Epipelagic (talk) 21:21, 30 January 2025 (UTC)

"Current AI" probably shouldn't be used at all. --Hipal (talk) 21:29, 30 January 2025 (UTC)

Well you can use older versions of AI if that's more comfortable. Please be clear I am not proposing a policy of using AI outputs as citations in articles. That would be as ridiculous as not being willing to see if you can refute an AI output if the challenge is reasonably presented on a talk page. — Epipelagic (talk) 21:53, 30 January 2025 (UTC)

Nobody is here to argue with bots. MrOllie (talk) 21:54, 30 January 2025 (UTC)

AI has moved way past the traditional bot — Epipelagic (talk) 22:03, 30 January 2025 (UTC)

Consistent with Wikipedia policy, an objective approach to the issue is already provided by the reliably sourced content in the article. Please see WP:RS. It might also help to review WP:NOT, specifically its subsections WP:SOAP and WP:FORUM. JoJo Anthrax (talk) 21:36, 30 January 2025 (UTC)

Yes, thank you for that flurry of wikilawyering. Now can you start over again and take a fresh look at the article? – Epipelagic (talk) 21:58, 30 January 2025 (UTC)

Epipelagic, I don't know what you'd like us to do. For now at least, there aren't any AIs that qualify as an RS. I never think of Wikipedia as 'in competition' with AI -- when, AI can write good articles, I'll be happy to let it. But for now, AIs can't cite sources and will randomly hallucinate. We're just left with your argument that EMDR isn't pseudoscience -- but if you note, the article doesn't actually say that it is. Feoffer (talk) 22:28, 30 January 2025 (UTC)

Oh dear... more random diversions. Aside from a large out-of-date section on how it is a pseudoscience, the article is categorised as pseudoscience. And we are back again with the pretence that the issue is about reliable sources. And additionally the issue now mysteriously includes AI writing Wikipedia articles?

To clarify, yet again, what this thead is about: it is a challenge to refute the AI assessment of whether EMDR is a pseudoscience, particularly by examining the scientific research over the past decade. Anyway, that is clearly not happening. Thank you gentleman for these clarifications on why the article is and must remain in the state it is. — Epipelagic (talk) 23:41, 30 January 2025 (UTC)

To clarify, yet again, what this thead is about: it is a challenge to refute the AI assessment of whether EMDR is a pseudoscience, look talk pages are not a WP:FORUM for debate. We don't need a "challenge to refute the AI". That is a waste of time. The AI isn't providing any WP:RS, just repeats whatever it scraped from some clinic websites. Zenomonoz (talk) 01:19, 31 January 2025 (UTC)

Yet again goes the ludicrous claim about using AI as a reliable source! I have never advocated using AI output as a reliable source. It changes, it can be wrong, it can hallucinate and even lie. Also, AI is not a unitary thing – there are different versions with different strengths and weaknesses. Please don't make that nonsense claim again!

Even so, AI is becoming increasingly perceptive. The AI output used here distills, or in a sense "repeats what it scrapes", from some of the most powerful AI machines. That is a lot more formidible than just "clinic websites". AI may be at the cusp where it is appropriate and helpful sometimes for editors to consider the validity of selected AI output on article talk pages. Certainly not treating it as though it were a reliable source and blindly accepting the output just because it is AI – but to consider it's validity. — Epipelagic (talk) 02:42, 31 January 2025 (UTC)

Epipelagic, I'm not making any argument, I'm sincerely listening in good faith! I don't have any pre-formed conception about EMDR. I write about REALLY fringe things like Dianetics, Scientology, Mormonism, UFO believers, Nation of Islam and I try to help give them all a fair presentation, not attack them for being a little different. If humans are doing something, it's up to us to describe it and help readers understand it, not just proscribe it. But we've gotten a little far afield here, with meta-discussions about AI. I have no ax to grind against EMDR -- how can we make the article better, specifically? Feoffer (talk) 03:39, 31 January 2025 (UTC)

Regardless of your opinion, I hope some of you will participate in the discussion I started a week ago: Reference review and related undue weight discussion. For example, if you know of any "new" (since ~2015) systematic review articles (or similar good secondary sources) on EMDR efficacy, please add them to the list I started. Also, of course, comment on anything I've added or respond to my remarks. In other words, let's discuss the scientific evidence, pro or con, and then decide if newer evidence should lead us to modify the article's content and tone or not. Many thanks -- Mark D Worthen PsyD (talk) [he/him] 15:42, 31 January 2025 (UTC)

P.S. Please correct any formatting errors or sources of confusion in that section I started. It looks funky on my phone, but I cannot figure out why. I welcome any formatting changes that would improve usability and reader experience. Thanks! -- Mark D Worthen PsyD (talk) [he/him] 15:44, 31 January 2025 (UTC)

The best available sources, particularly WP:MEDRS sources, agree that EMDR is a form of pseudoscience. a type of "purple hat therapy" and that the individual or unique features of EMDR are not the source of its efficacy. — Shibbolethink ^{(♔ ♕)} 20:52, 31 January 2025 (UTC)

Shibbolethink, I'm aware of this recent source that might fit your claim – and that seems more a blog entry than a formal academic review. Would you mind listing the other recent sources that fit your claim. – Epipelagic (talk) 00:24, 1 February 2025 (UTC)

Probably worth noting here that WP:RSN has recently cast a lot of doubt on SBM articles written by the editors of SBM, like this one was. Loki (talk) 07:29, 1 February 2025 (UTC)

They very specifically do not. None of the big WP:MEDORG sources say this and many explicitly endorse EMDR as an evidence-based therapy. Just because you can find academics that say this does not mean they are the WP:BESTSOURCES. Loki (talk) 00:07, 1 February 2025 (UTC)

We've been over this many times. That a source is silent on a point cannot be construed to mean it disagrees with a point. That a purple hat therapy is effective does not mean it is scientific. MrOllie (talk) 00:24, 1 February 2025 (UTC)

If a source is silent on a point can it be construed to mean it agrees with a point? Mark D Worthen PsyD (talk) [he/him] 04:02, 1 February 2025 (UTC)

I haven't claimed anything of the sort, so you should follow up with whomever it is that did. MrOllie (talk) 04:14, 1 February 2025 (UTC)

You wrote: "That a source is silent on a point cannot be construed to mean it disagrees with a point." Is it not also true that if a source is silent on a point, it cannot be construed to mean it agrees with a point? Mark D Worthen PsyD (talk) [he/him] 04:34, 1 February 2025 (UTC)

I'm not really interested in debating hypotheticals. Again: take it up with someone who has actually made such a claim. MrOllie (talk) 04:35, 1 February 2025 (UTC)

I am talking about logic, not hypotheticals. Mark D Worthen PsyD (talk) [he/him] 04:37, 1 February 2025 (UTC)

Ok. I still think it's irrelevant to this article. Feel free to take the last word of you require it, I won't respond to this tangent again. MrOllie (talk) 04:47, 1 February 2025 (UTC)

The deeper issue here is that if we have, say, 10 sources that say EMDR is evidence-based and effective without technically commenting on whether or not it's a purple hat therapy, and two sources that say "it's only effective because it's a purple hat therapy", we can't represent "it's a purple hat therapy" as the academic consensus per WP:DUEWEIGHT. This is especially true since the large number of sources that say EMDR is effective are big international WP:MEDORGs that are explicitly trying to represent the consensus of the field, while the sources that say it's a purple hat therapy are individual articles or books that only claim to represent the professional opinion of their specific authors.

I'll also add that some academic sources do claim that EMDR has some mechanism of action tied to the eye movements specifically. While this is definitely a more contentious claim than the bare fact that EMDR is an effective treatment for PTSD in adults, it is an explicit contradiction of the purple hat therapy claim: the eye movements can't be a purple hat if they're a part of the effectiveness of the treatment. Loki (talk) 07:11, 1 February 2025 (UTC)

But "evidence-based" and "pseudo-scientific" aren't mutually exclusive. Traditional "bone-setters" are pseudoscientific, but evidence shows they have effectiveness. Feoffer (talk) 04:34, 1 February 2025 (UTC)

Traditional bone-setters aren't really pseudoscientific by the definition we use. They're more pre-scientific. The harder example is something like chiropractic, which is definitely pseudoscientific but may be effective for back pain. But even then, to the extent it's evidence-based it's not pseudoscientific and to the (much larger) extent it's pseudoscientific it's not evidence-based.

Pseudoscience is a pattern of defense against contradictory evidence: a pseudoscience claims to be an ordinary evidence-based science but retreats to unfalsifiable claims in response to contradictory evidence. A traditional claim that is borne out by scientific evidence becomes a scientific claim. Loki (talk) 07:25, 1 February 2025 (UTC)

Well to be honest, I originally wrote my comment about Chiropractic, but switched it to bonesetter to avoid opening another can of worms! lol very perceptive. Feoffer (talk) 15:51, 1 February 2025 (UTC)

Shibbolethink What are your criteria for deciding which reliable sources are "best"? -- Mark D Worthen PsyD (talk) [he/him] 04:11, 1 February 2025 (UTC) Mark D Worthen PsyD (talk) [he/him] 04:11, 1 February 2025 (UTC)

Talk page sealioning

This talk page is an absolute torrent of "sealioning", wall of texts absolutely impossible to read, tengantial, hypothetical, whataboutist arguments, etc. Kudos to the people holding the fort, but there seem to be some "bad faith actors" that are given a little too much leeway and seemingly taking up valuable time from reasonable editors while having nothing to contribute. It's difficult to assume good faith at this point; the case can be made (and reviewed) very quickly, and yet is dragged on to no end. It should probably be stopped before attrition sets in. DommageCritique (talk) 15:41, 1 February 2025 (UTC)

Is EMDR pseudoscience?

I agree with the comment immediately above, and would like to reframe and reboot the thread I initiated above. The specific issue that thread came down to was whether or not EMDR is pseudoscience. Relevant points (and claims) that have already been made are:

The best available sources, particularly WP:MEDRS sources, agree that EMDR is a form of pseudoscience. a type of "purple hat therapy" and that the individual or unique features of EMDR are not the source of its efficacy. — Shibbolethink ^{(♔ ♕)} 20:52, 31 January 2025 (UTC)

They very specifically do not. None of the big WP:MEDORG sources say this and many explicitly endorse EMDR as an evidence-based therapy. Just because you can find academics that say this does not mean they are the WP:BESTSOURCES. Loki (talk) 00:07, 1 February 2025 (UTC)

Shibbolethink, I'm aware of this recent source that might fit your claim – and that seems more a blog entry than a formal academic review. Would you mind listing the other recent sources that fit your claim. – Epipelagic (talk) 00:24, 1 February 2025 (UTC)

Probably worth noting here that WP:RSN has recently cast a lot of doubt on SBM articles written by the editors of SBM, like this one was. Loki (talk) 07:29, 1 February 2025 (UTC)

— Epipelagic (talk) 18:10, 1 February 2025 (UTC)

This issue can be rapidly settled by establishing there are indeed reasonably current available sources in line with Shibbolethink's claim (immediately above). Shibbolethink is the main contibutor to the current EMDR article, and clearly is well positioned to substantiate his claim. Alternatively, can anyone else provide the sources he speaks of? — Epipelagic (talk) 05:02, 2 February 2025 (UTC)

Sources describing EMDR as a pseudoscience

• Bernhard M. The Enigmatic Method. Virginia Quarterly Review. 2023;99(1/2):172-184. (Not a MEDRS, but summarizes and references MEDRSes.)

• • "The most strident critics called EMDR a pseudoscience, while others contended that it was nothing more than exposure therapy with a bit of hand-waving. Some clinicians still contest its efficacy, as research into EMDR remains plagued with quality issues like small sample sizes and limited follow-up data. McNally summed up the criticism with one neat line: “What is effective in EMDR is not new, and what is new is not effective.”"

• Are Pseudosciences Like Seagulls? A Discriminant Metacriterion Facilitates the Solution of the Demarcation Problem. By: Fasce, Angelo, International Studies in the Philosophy of Science, 02698595, Sep-Dec2019, Vol. 32, Issue 3/4 (Not a MEDRS, but summarizes and references MEDRSes.)

• • "In Fasce ([20]) I developed a demarcation criterion that fulfils the requirements of this discriminant metacriterion, where pseudoscience radically differs from science regarding domain, method, and evidence. So, it can be identified by being uncontroversially outside the domain of science, particularly due to untestable content — such as reiki, morphic fields, acupuncture's qi, and vertebral subluxations — and through the use of radically flawed methods — for example research on EMDR without controlling exposure"

• The messy landscape of eye movements and false memories. By: Kenchel, Jillian M., Domagalski, Kirsten, Butler, Brendon Jerome, Loftus, Elizabeth F., Memory, 09658211, Jul2022, Vol. 30, Issue 6 (A high quality MEDRS.)

• • "However, empirical support for the contribution of EM is mixed at best...Ost stepped into this battlefield when he criticised the endorsement of EMDR by NICE (National Institute for Health and Care Excellence) in England, stating evidence that "a closer look at dismantling studies would have shown that only the desensitisation component (D) appears to be active, whilst the novel eye movement (EM) and reprocessing (R) components appear to be inert and have no coherent theoretical underpinning"...Evidence also exists suggesting that reprocessing (R) does not bear additional therapeutic benefits...Thus, the desensitisation component of EMDR, which closely resembles beneficial components of existing exposure therapies, such as cognitive behavioural therapy (CBT), may be the only efficacious part of the treatment, leading critics to suggest that EMDR is merely another brand of exposure therapy."

Here you go. — Shibbolethink ^{(♔ ♕)} 14:28, 2 February 2025 (UTC)

Excellent. Thank you Shibbolethink. Now we have the beginings of ground and can make some progress. Are there other reasonably current available sources, particularly WP:MEDRS sources, pointing to EMDR as pseudoscience? Anyone? If so, please add them here. — Epipelagic (talk) 19:57, 2 February 2025 (UTC)

Looking at Shibbolethink's sources...

• The Enigmatic Method: Is EMDR a psychotherapeutic breakthrough, pseudoscience, or a little bit of both?. Seems to be a summary of maybe relevant papers, but is behind a paywall where I have no access. Is not a MEDRS and has just 1 citation. Perhaps someone with access can find further relevant sources in this paper?
• Are Pseudosciences Like Seagulls? A Discriminant Metacriterion Facilitates the Solution of the Demarcation Problem More a philosophical paper which mentions EMDR just once, citing one 26 year old flawed paper. Not a MEDRS.
• The messy landscape of eye movements and false memories Comfortably MEDRS, but does not seem to mention pseudoscience, and has limited scope, being focussed on false memories rather than providing a general overview of EMDR.

The most interesting source I can find is perhaps this very recent one (October 23, 2024):

• EMDR Is Still Dubious published as a kind of blog by an organisation called Science Based Medicine (SBM). In a discussion above, Loki noted that WP:RSN has cast doubt on SBM articles written by the editors of SBM.

I cannot find further recent sources that seem relevant. Going back into history, the most influential and most cited relevant source seems to be:

• Science and pseudoscience in the development of eye movement desensitization and reprocessing: Implications for clinical psychology from 25 years ago. According to Google Scholar, about 69,800 publications to date have mentioned EMDR. Only 2,100 of those publications mentioned EMDR 25 years ago. That means that since that paper was written, 25 years of scientific activity has occurred resulting in 30 times the number of scientific publications mentioning EMDR. This paper is currently used in the Wikipedia article as a source supporting the position that EMDR is pseudoscience. I suggest it is too dated to be used that way.

Is this an accurate and sufficient account of the most relevant sources? — Epipelagic (talk) 05:04, 4 February 2025 (UTC)

I'm pretty sure it's not, because I definitely remember there were some short mentions in long books. Check the sources of the article itself.

I'm also curious about that first source, because it seems like it's very relevant as an overview of the whole debate. Loki (talk) 05:41, 4 February 2025 (UTC)

There doesn't seem to be accounts in recent books making exemplary cases for EMDR as pseudoscience. A number of them briefly indulge in dismissive handwaving, and maybe reference the 25-year-old Herbert et al. paper with bright approval. Initially, I didn't have a position on whether EMDR was a pseudoscience or not. However, increasingly, I am coming to the view that it seems to be partially pseudoscience. At least some of the attempts to provide it with theoretical underpinnings seem in that category. On the other hand, EMDR applied to PTSD as a practical therapeutic mode seems at least as effective, if not more effective than other therapies. Then again, it is possible that the eye movements are not really essential, not what's at the core of the therapeutic effect. But no one seems to have definitively proven that. So like Loki, I'm interested to know what is in the paper with the title in the form of a question, "Is EMDR a psychotherapeutic breakthrough, pseudoscience, or a little bit of both?". I'm inclined towards thinking that, at present, that question should be answered "a little bit of both", and that the Wikipedia article should clearly reflect that. However, sources on both sides seem messy when it comes to trying to bring things together. — Epipelagic (talk) 07:49, 4 February 2025 (UTC)

spelling error

I can't edit, but "sudotherapy" should be "sudotherapay" 216.229.95.146 (talk) 13:40, 3 February 2025 (UTC)

Revising the article

I suggest we revise the article along the lines of the suggested revision to the lead section (below). I hope you are willing to work together to achieve consensus.

Suggested revision to lead section

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy designed to treat post-traumatic stress disorder (PTSD). It was devised by Francine Shapiro in 1987.

EMDR involves talking about traumatic memories while engaging in side-to-side eye movements or other forms of bilateral stimulation. It is also used for some other psychological conditions.

EMDR is recommended for the treatment of PTSD by various government and medical bodies citing varying levels of evidence, including the World Health Organization, the UK National Institute for Health and Care Excellence, the Australian National Health and Medical Research Council, and the US Departments of Veteran Affairs and Defense. The American Psychological Association suggests EMDR may be useful for treating adult PTSD.

Systematic analyses published since 2020 suggest that EMDR treatment efficacy for adults with PTSD is equivalent to trauma-focused cognitive and behavioral therapies (TF-CBT), such as Prolonged exposure therapy (PE) and Cognitive Processing Therapy (CPT). However, bilateral stimulation does not contribute substantially, if at all, to treatment effectiveness. The predominant therapeutic factor in EMDR and TF-CBT is exposure.

EMDR has been characterized as a purple hat therapy, i.e., only as effective as its underlying therapeutic methods without any contribution from its distinctive add-ons.

Rational for specific changes to the lead section I realize that, in general, "lead follows body". I am posting this suggested lead section as a way to discuss the type of revisions I believe this article needs. And I list below my reasons for specific changes.

• "but remains controversial within the psychological community" - Remove. This was true 20 years ago, but not today. Some aspects, e.g., claiming that bilateral stimulation significantly contributes to treatment efficacy, is debated (and that point is addressed elsewhere in this suggested lede).

• "EMDR involves focusing on traumatic memories in a manner similar to exposure therapy" - Remove because it is incorrect. EMDR does not emphasize systematic repeated exposure.

• "There is debate about how the therapy works" - true, but perhaps not needed in the lede (I'm fine leaving it if a majority feel really strong about it.)

• "... and whether it is more effective than other established treatments." - Remove. No debate in recent years - it is not more effective than established treatments. It's either equivalent to, or somewhat less effective than, the TF-CBT approaches.

• "Treatment guidelines note EMDR effectiveness is statistically the same as trauma-focused behavioral therapy ..." - Change to: "Systematic analyses published since 2020 suggest that EMDR treatment efficacy for adults with PTSD is equivalent to trauma-focused cognitive and behavioral therapies (TF-CBT), such as Prolonged exposure therapy (PE) and Cognitive Processing Therapy (CPT)." → Why? To improve accuracy and precision.

• "the Australian National Health and Medical Research Council notes that this may be due to including most of the core elements of cognitive behavioral therapy (CBT)" - Remove. Exposure therapy is the core element. "CBT" covers a lot of territory. → Instead, I suggest: "The predominant therapeutic factor in EMDR and TF-CBT is exposure."

• "The eye movements have been criticized as having no scientific basis." - Remove. Imprecise and repetitive.

• "The founder promoted the therapy for the treatment of PTSD, and proponents employed untestable hypotheses to explain negative results in controlled studies." - Remove. Editorial language ("promoted") and an unnecessary, outdated, and largely irrelevant criticism. If it's important to include, which I doubt, it should be in a "History" subsection.

• "EMDR has been characterized as a pseudoscientific ..." - Remove the word, pseudoscientific. Highlighting a small minority's accusations of pseudoscience, when none of the major scientific organizations use this term, does not make sense.
• "purple hat therapy" - Keep, because it is a valid criticism supported by reliable sources.

Mark D Worthen PsyD (talk) [he/him] 01:32, 6 February 2025 (UTC)

I support this, though I might add "Because of this, " before the last sentence. Loki (talk) 07:40, 7 February 2025 (UTC)

That makes sense. -- Mark D Worthen PsyD (talk) [he/him] 12:57, 9 February 2025 (UTC)

Hmm, actually: are we sure we have sources that verify the primary therapeutic factor in TF-CBT is exposure? The usual claim is that the therapeutic factor in CBT is a combination of cognitive and behavioral factors, where exposure is the main behavioral factor. I'm not sure we should be making claims to the contrary unequivocally; if we do we'd need strong sourcing. Loki (talk) 07:45, 7 February 2025 (UTC)

Good point. I am not sure why I included "TF-CBT" in that sentence. The correct sentence is: "The predominant therapeutic factor in EMDR is exposure." Mark D Worthen PsyD (talk) [he/him] 13:08, 9 February 2025 (UTC)

And, I will look at the sources again and see if, in fact, that would be the most accurate way to portray it. Mark D Worthen PsyD (talk) [he/him] 13:11, 9 February 2025 (UTC)

After reviewing relevant sources, I concluded that you are right Loki. I very much appreciate your response and pointing out this issue. :-)

I edited the lead (diff) and modified the last two paragraphs based on your corrective feedback. Copy edits welcome to improve clarity of expression, grammar, syntax, etc.

I will continue to (very gradually) work on this article, in part to achieve congruence between the lead and the body. -- Mark D Worthen PsyD (talk) [he/him] 07:26, 12 February 2025 (UTC)

Reorganization

I made several changes (diff) in an effort to establish more logical and coherent organization to the article, and to align it with similar articles on psychotherapy approaches (consistency). I do not assume that my organizational ideas are the best, but I hope you agree that consistency with similar psychotherapy articles is desireable (to the extent that is possible - there's a lot of variation, unlike many biomedical articles which have a clearly defined structure), and that the previous structure was quite hodge-podge. I removed a subheading that had no text in it, and made a couple of other changes to text, but nothing major (unless I'm forgetting something)—I tried to focus on organization. -- Mark D Worthen PsyD (talk) [he/him] 11:42, 12 February 2025 (UTC)

And some more edits (diff) to update, in part by removing conclusions based on articles from 14–19 years ago that have been superceded by more recent systematic reviews; but also retaining many of the criticisms that I believe are overemphasized, but I did not remove them. -- Mark D Worthen PsyD (talk) [he/him] 12:34, 12 February 2025 (UTC)