Talk:Eye movement desensitization and reprocessing/Archive 2

Archive 1

all my comments were removed

The changes i made on Monday appear to have been removed without discussion.

I changed the previous content because it was out of date and inconsistent with emerging literature (last two years). This was necessary as the conclusions on the pages were firstly at odds with the findings of committees from around the world that EMDR is evidence based practise. Hence the section titled ‘Effectiveness: expert consensus guidelines’. Their resultant views are likely to present a more balanced view than what I read when I opened the page last week. I think this section needs to stay and only be chaged when new guidelines emerge.

Secondly any suggestions that the treatment is not an empirically supported is absurd. Especially given recent studies such as Van der Kolk's et al (2007) work published in the Journal of Clinical Psychiatry that EMDR out performed Fluoxetine, Rothbaums large and very rigorous study published in Journal of Traumatic Stress on EMDR versus traditional exposure, the most recent meta-analytic study by Shidler and Wagner (2006) in Psychological Medicine. Any discussion on effectiveness needs to consider current studies.

Thirdly the article ignores reviews and a process study by implying that EMDR works the same as traditional exposure. WE now know this does not seem to be the case for details see Lee, C. W., Taylor, G., & Drummond, P. (2006). The active ingredient in EMDR; is it traditional exposure or dual focus of attention? Clinical Psychology & Psychotherapy, 13, 97-107. Any discussion on mechanism of action needs to account for process studies on the methods.

Finally I found it very odd that a science based publication was describing the recent history of what happened to an institution that once provided training to a currently licensed practitioner. Seemed liked a personal attack to me not a scientific argument.

—The preceding unsigned comment was added by Dr Chris Lee (talk • contribs) 05:33, 21 March 2007 (UTC).

I appreciate all the effort that you made, and agree that it is important Wikipedia articles be current. I suggest however that a section on CONTROVERSIES be added, as this is an important part of EMDR's history. Also there are still some individuals who are opposed to this therapy. Lmaxfield 10:52, 21 March 2007 (UTC)

Outside reader

Hey, what happened to the debate, the criticism, the scientific research, the citations? Did that last editor Lmaxfield mean to remove it all?Fainites 21:44, 25 February 2007 (UTC)

Hi My effort was to remove the many errors in the article, and to update it with accurate scientific information. EMDR is an established psychotherapy. I retained mention of the critics. I emphasized the scientific research and added citations. I added many more citations than the original article contained. Do you want more citations? I would be happy to add more; I was not sure how many there should be. For example, there are about 20 randomized clinical trials on PTSD treatment with EMDR; 10 of these are recent. Do you want the citations for all these? Also there are 5 meta-analyses showing EMDR and CBT equivalence. I only cited 2. SHould the others be added? Also there are about 10-12 international treatment guidelines stating that EMDR is a level A recommended treatment for PTSD. SHould these be added as well? thanks Louise Maxfield

Maybe I was looking at it when you were in the middle of it all as yesterday evening all scientific citations had disappeared! I was just posting a warning in case it was vandalism. Glad to see them all back. I've added a link to Devilly 2002 Fainites 18:24, 26 February 2007 (UTC)

Thanks. I notice that the footnotes are not showing up on the page. Is there something I am missing about how to make that Happen? Thanks Louise Maxfield

I've gone through the first paragraph and fixed the refs and given you a proper notes and references section. If you type out the refs properly (just copy what I did or look at this link cos it's different for books,[1]) it does all the refs for you. Once you've fixed all the refs you can get rid of the previous ref section. You need to add in the full title and citation. The idea being than anybody can then look it up, either by googling the title and name, or preferably if you can add a direct link. If you want any more help, don't hesitate to ask, but I've not that long worked out how to do it myself! Also, your posts don't give your name and time and date. If you're logged in, just press 4 tildas and it does it automatically.

on content, I don't think that if there are 5 meta-analysis you should only add two positive ones in the intro when the biggest, Devilly's, is not positive.Fainites 22:19, 26 February 2007 (UTC)Also the Bradley one has huge limitations.Fainites 22:35, 26 February 2007 (UTC)

By the way, there's a message on your talk page from one of the regular editors here.Fainites 22:27, 26 February 2007 (UTC)

I've fixed all the refs in a proper notes and refs section which now link to all the little ref numbers in the article so the refs now work. They are not complete as they need PMID or ISSN numbers. Also the ones that are books should be set out differently to research or other peer reviewed papers. I haven't removed the old ref section as there are some articles in there that didn't have links to ref numbers so somebody needs to sort these out as proper refs.Fainites 17:19, 27 February 2007 (UTC)

Major rewrites

Some anonymous user User:58.178.125.188 has taken it upon himself to majorly rewrite the article... are we happy with the changes? Kat, Queen of Typos 00:09, 19 March 2007 (UTC)

Although I have not edited content, I did redo all your references in a workable form. I note the rewrite has removed the majority of references, including any that were mildly critical and also some meta-analysis, eg Lilienfield and Devilly, both major players in experimental psychology. The whole article is now an inaccurate advertising puff. Whoever did it has also scattered little numbers throughout which look like references but actually aren't and don't link to anything. I'd revert the whole lot and invite whoever did it to discuss on the talkpage first. I know nobody owns articles, but removing all controversy and verified and credible references wholesale is against wiki policies. Fainites 18:05, 19 March 2007 (UTC)

Maybe the entire article should be reverted to a version before that anon user edited this. There are now footnotes (36) that are linked to nothing and no citations are provided. I propose that we begin again with the version before anon user 58.178... OK?DPeterson^talk 22:03, 19 March 2007 (UTC)

I agree with DP. Fainites 22:16, 19 March 2007 (UTC)

Thanks, Faintes. So, unless I hear any comment to the contrary, I will do this in the next couple of days...leaving some time for others to comment. DPeterson^talk 23:03, 19 March 2007 (UTC)

I agree also. Fainites, I wasn't referring to your edits. You were signed in. :) I posted on the anon user's talk page to invite him/her here, but apparently he/she hasn't come. Kat, Queen of Typos 06:05, 20 March 2007 (UTC)

Actually some of the edits are very detailed, but unfortunately as there are no references it's impossible to check their validity. I did wonder if it was a newbie who just doesn't yet understand how to set up references and therefore needs assistance, but removing existing references does not bode well. On a quick check he's removed 7 out of 18 references including all the meta-analyses and any critical scientific analysis (except the sceptics dictionary which doesn't really count and he attempted to remove that [2]!). Fainites 18:43, 20 March 2007 (UTC)

I did the revert...maybe now we can add back what was relevant and sourced. DPeterson^talk 22:50, 20 March 2007 (UTC)

I thought that the new editor did a nice job of polishing the material, bringing it up to date with factual information. It looks to me as though the new references are now working. I'd like to suggest that we add a NEW SECTION -- called CONTROVERSIES so that controversial comments are not interspersed throughout the whole article, which will only foster dissension. That new section can contain the material from Devilly and Lillienfeld. Lmaxfield 10:48, 21 March 2007 (UTC)

That's a good idea Lmaxfield. Kat, Queen of Typos 11:45, 21 March 2007 (UTC)

I'm on the same page with you two. I like the recent edits...very good. I was also thinking that something about any controversies needed to be added and creating a specific section for that is a great idea. RalphLender^talk 14:10, 21 March 2007 (UTC)

Sounds reasonable to me.Fainites 17:54, 21 March 2007 (UTC)

all my comments were removed

The changes i made on Monday appear to have been removed without discussion.

I changed the previous content because it was out of date and inconsistent with emerging literature (last two years). This was necessary as the conclusions on the pages were firstly at odds with the findings of committees from around the world that EMDR is evidence based practise. Hence the section titled ‘Effectiveness: expert consensus guidelines’. Their resultant views are likely to present a more balanced view than what I read when I opened the page last week. I think this section needs to stay and only be chaged when new guidelines emerge.

Secondly any suggestions that the treatment is not an empirically supported is absurd. Especially given recent studies such as Van der Kolk's et al (2007) work published in the Journal of Clinical Psychiatry that EMDR out performed Fluoxetine, Rothbaums large and very rigorous study published in Journal of Traumatic Stress on EMDR versus traditional exposure, the most recent meta-analytic study by Shidler and Wagner (2006) in Psychological Medicine. Any discussion on effectiveness needs to consider current studies.

Thirdly the article ignores reviews and a process study by implying that EMDR works the same as traditional exposure. WE now know this does not seem to be the case for details see Lee, C. W., Taylor, G., & Drummond, P. (2006). The active ingredient in EMDR; is it traditional exposure or dual focus of attention? Clinical Psychology & Psychotherapy, 13, 97-107. Any discussion on mechanism of action needs to account for process studies on the methods.

Finally I found it very odd that a science based publication was describing the recent history of what happened to an institution that once provided training to a currently licensed practitioner. Seemed liked a personal attack to me not a scientific argument.

—The preceding unsigned comment was added by Dr Chris Lee (talk • contribs) 05:33, 21 March 2007 (UTC).

I appreciate all the effort that you made, and agree that it is important Wikipedia articles be current. I suggest however that a section on CONTROVERSIES be added, as this is an important part of EMDR's history. Also there are still some individuals who are opposed to this therapy. Lmaxfield 10:52, 21 March 2007 (UTC)

Dr Chris Lee may be new to Wikipedia and unsure of how it works, but I did warn him on his talk page that we were going to revert the edits because of the anonymous user's edits prior to his - so no, the edits were not reverted without discussion. Kat, Queen of Typos 05:09, 23 March 2007 (UTC)

re reply to [User:Lmaxfield|Lmaxfield]

You are right a section on matters that are still controversial needs to be added I have done so and welcome any additional comments you wish to make Dr Chris Lee —The preceding unsigned comment was added by Fainites (talk • contribs) 14:48, 22 March 2007 (UTC).

I like the additions...helpful.RalphLender^talk 16:30, 22 March 2007 (UTC)

Devilly's 2002 meta-analysis concludes (1) There is overwhelming evidence that eye movements are neither a necessary nor a useful addition to the procedure; (2) there is strong and consistent evidence that EMDR is better than no treatment, yet only as good as any other treatment that utilizes some aspect of exposure therapy; and (3) there is strong evidence that a full-exposure-based intervention package is superior to EMDR. There is also some evidence that "reprocessing" is likewise superfluous to EMDR and that the effects of EMDR dissipate over time. I think a synopsis of this could go in the controversy section. Fainites 22:45, 22 March 2007 (UTC)

Good points.SamDavidson 23:20, 22 March 2007 (UTC)

How about, Devilly (2002) in a review and meta-analysis concludes that although EMDR is effective, it is because it operates as an exposure therapy for which the eyemovements are unecessary, and is neither as effective nor as long lasting as specific exposure therapy.Fainites 22:51, 24 March 2007 (UTC)

I think you could add that and it would certainly be an improvement. DPeterson^talk 00:08, 25 March 2007 (UTC)

Done. Fainites 19:09, 25 March 2007 (UTC)

I also think for completeness sake the controversy section ought to contain a synopsis of the Herbert, Lilienfield meta-analysis. Fainites 19:21, 25 March 2007 (UTC)

Meta-analysis

I have had to make changes to material reported in the devilly meta-analysis given we now have two more recent studies. Both looked at traditional exposure therapy and EMDR and found that they led to equivalent outcomes at follow-up (Bradley, Greene, Russ, Dutra, & Westen, 2005; Seidler & Wagner, 2006). This now appperas in the effectiiveness section. Also we do know that at 18 month follow-up treatment is still effective(Edmond & Rubin, 2004). Recent studies suggest that traditional exposure treatments may not be so robust over time unless cognitive therapy is included in the package (Tarrier & Sommerfield, 2004).

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A Multidimensional Meta-Analysis of Psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214-227. Edmond, T., & Rubin, A. (2004). Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA. Journal of Child Sexual Abuse, 13(1), 69-86. Seidler, G. H., & Wagner, F. E. (2006). Comparing the efficacy of EMDR and trauma-focused Cognitive-Behavioral Therapy in the Treatment of PTSD: a meta–analytic study Psychological Medicine 36 1515-1522. Tarrier, N., & Sommerfield, C. (2004). Treatment of Chronic PTSD by Cognitive Therapy and Exposure: 5-Year Follow-Up. Behavior Therapy, 35(2), 231-246.

Chris Lee

I would only quibble with the construction of that paragraph as it says since then and then quotes 4 studies that predate Devilly!Fainites 13:08, 26 March 2007 (UTC)

Hi Fainites. Yes, this page has turned into nothing but a promotional page for EMDR. It's pointless editing by experts in the area because people who have a vested interest in EMDR will just edit those comments back out again. The same goes for the NLP page and all the other powertherapies pages. From their perspective their income is at stake not science. Ho-hum. Grant

Would you not make such sweeping statements? I have no vested interest in EMDR, myself, and I watch this page. Would you please just make your changes? Some of this stuff you guys talk about in here is over my head, but I try to understand... I don't understand doctor-speak sometimes, but I don't know that I see people editing out because they have a vested interest. Kat, Queen of Typos 21:11, 7 August 2007 (UTC)

Dear Kat, I have made edits and changes and they just get edited out - so it's pointless. And yes, I am the "Devilly" who has done all the research on this topic. That is my point. My question is: why would someone who doesn't understand "doctor-speak" be editing a page on treatment strategies? Grant

Have you read Wikipedia's policy on not being too technical? These articles need to be accessible to normal people - as it is it's already borderline too technical, IMO. Kat, Queen of Typos 07:12, 8 August 2007 (UTC)

importance rating

EMDR is a pretty hot topic in psychology and is quickly becoming one of the most widely used (for better or for worse) methods in all of clinical psychology. it should at least be of medium if not high importance...128.239.158.219 04:57, 5 April 2007 (UTC)albwus

Do you have a source for that? Kat, Queen of Typos 05:13, 5 April 2007 (UTC)

I agree with a medium rating. SamDavidson 17:11, 6 April 2007 (UTC)

Who decides the ratings? Fainites 20:47, 6 April 2007 (UTC)

Review of newest section needed

User:68.146.133.56 has added a long section on how post-traumatic stress causes an immediate reaction to past traumas - I think it needs a review, and may possibly be more appropriate in the article about PTSD. Kat, Queen of Typos 02:38, 10 July 2007 (UTC)

Since no one seems interested in commenting, I've removed it - I don't think it fits this article well. Kat, Queen of Typos 21:22, 7 August 2007 (UTC)

Reference edit needed

I do not edit references well... at the end of the first paragraph, it says "Appendix A. Handbook of EMDR and Family Therapy Processes. New York: Wiley." - could someone edit that into a proper ref link? Kat, Queen of Typos 21:20, 7 August 2007 (UTC)

Done. As well, I'm changing the journal references to follow the tamplate on this page, for standardization as per WP:MEDMOS. One distinct advantage is having the link to the abstact of the article, which makes the research more accessible. I'm just giving this heads-up so nobody thinks I'm making wild changes for no good reason. Absentis 17:43, 14 August 2007 (UTC)

Any relation to dianetics?

I read the Dianetics book quite a while ago, so I may be remembering incorrectly, but this therapy seems similar to the engram clearing talked about in that book. Was just wondering if anyone else knew of a connection between the two?Ronar 17:25, 14 August 2007 (UTC)

I don't know much about dianetics, but I've never heard them compared. Kat, Queen of Typos 07:23, 15 August 2007 (UTC)

Meta analysis criticism

Removed text: However, this analysis has a methodological flaw. The degrees of freedom used to examine the level of significance of the effect was based on the number of studies rather than the number of participants which is the convention. When this is corrected, the actual effect size obtained of r=.15 (eye movement over no eye movement) is significant.

I doubt the veracity of these statements for a few reasons. Firstly, the criticism comes from a source with a vested interest in EMDR, and was not published in an academic journal. Secondly, a well-known researcher from the IoP stated that the meta-analysis was "well done". Unfortunately, my knowledge of statistics does not (yet) cover meta analysis, so I can't really say one way or the other. Is there an objective expert that can weigh in on this? Absentis 18:46, 15 August 2007 (UTC)

Eye movement controversy

Text: A recent review highlighted the evidence that the eye movement in EMDR does produce a differential effect. In contrast to no eye movement, eye movements produce changes in physiological measures including reductions in blood pressure, heart rate and galvanic skin response.
Some studies have supported a differential effect of eye movements over eyes stationary. In comparison to no eye movements and a passive visual interference task, eye movements resulted in a greater reduction in vividness of undergraduate students emotional memories. Similarly, memory recollections after eye movements were less vivid and less distressing compared to both a finger tapping and no dual-task control condition. Other dual tasks such as spatial tapping have also proven less effective than eye movements in reducing the distress and vividness of memories of personal experiences. However this differential effect for eye movement was not found for non personal memories such as photographs that contained distressing content. Subsequent research has shown that eye movement facilitates memory processing for episodic memory but not semantic memory. In fact the mean effect size for each study that has investigated eye movement over no eye movement was found to increase from .15 to .28, when studies of contrived traumas were removed from the analysis.
The effects of eye movements compared to an eye stationary condition was also investigated for both positive and negative memories. The eye movement condition yielded greater reductions than the eye stationary condition in vividness, subjective emotional arousal, and physiological arousal for memories connected with vivid images associated with fear and anxiety. The reduction in vividness also occurred with memories of positive experiences.

I've taken this text out of the section on 'eye movements' because it does not deal directly with whether or not eye movements are a necessary part of the therapy. This text is better suited to the section 'How does EMDR work?', and should be integrated together. Absentis 21:43, 18 August 2007 (UTC)

Effectiveness: expert consensus guidelines

I've hidden the text under this headline because I have trouble believing this kind of information belongs in an encyclopedia article. I could understand a reference to an organization in terms of the history of the therapy (like when the APA recognized it as a therapy) but to simply list all the organizations/associations that support the therapy is clearly POV pushing. Unless a clear consensus can be reached I'll delete the information in due time. Absentis 21:55, 18 August 2007 (UTC)

The APA never recognized it as a therapy. Read the text more carefully. FatherTree 14:19, 22 August 2007 (UTC)

Actually, this American Psychiatric Association PTSD treatment guideline (approved in June 2004) clearly shows they recognize EMDR as an effective therapy. Sadly, it is you who needs to read the text more carefully. Absentis 14:52, 22 August 2007 (UTC)

Read the disclaimer at the top. FatherTree 00:49, 23 August 2007 (UTC)

Not evidence based

Well I do not have to time to do this now. But I hope you realize that EMDR has never been proven to be effective. If you think it has please point me to the study. And many thousand if not millions of dollars will spent on it from a nearly bankrupt medical system so operators can make big bucks off of troubled people. FatherTree 14:19, 22 August 2007 (UTC)

Please read citations 11-25 in the article. These journal articles speak to the effectiveness of EMDR. If there are problems with any of them, please bring it up. Until then, Wikipedia is not your soapbox. Absentis 14:44, 22 August 2007 (UTC)