Talk:Eye movement desensitization and reprocessing#%22Pseudoscience%22 section

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:

::::: — 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 {{u|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)

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

• "{{tq|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.)

• "{{tq|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.)

• "{{tq|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 {{u|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 {{u|Shibbolethink}}'s sources...

::* [https://scholar.google.co.nz/scholar?hl=en&as_sdt=0%2C5&q=The+Enigmatic+Method%3A+Is+EMDR+a+psychotherapeutic+breakthrough%2C+pseudoscience%2C+or+a+little+bit+of+both%3F&btnG= 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?

::* [https://www.researchgate.net/profile/Angelo-Fasce/publication/341579033_Are_Pseudosciences_Like_Seagulls_A_Discriminant_Metacriterion_Facilitates_the_Solution_of_the_Demarcation_Problem/links/624afaa38068956f3c69c6d2/Are-Pseudosciences-Like-Seagulls-A-Discriminant-Metacriterion-Facilitates-the-Solution-of-the-Demarcation-Problem.pdf 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.

::* [https://escholarship.org/content/qt4f4670q3/qt4f4670q3_noSplash_c205a10b6d1a77ed30c27c257490c840.pdf 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):

::* [https://sciencebasedmedicine.org/emdr-is-still-dubious/ EMDR Is Still Dubious] published as a kind of blog by an organisation called Science Based Medicine (SBM). In a discussion above, {{u|LokiTheLiar|Loki}} noted that WP:RSN has [https://en.wikipedia.org/wiki/Wikipedia:Reliable_sources/Noticeboard/Archive_463#RFC_Science-Based_Medicine 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:

::* [https://scottlilienfeld.com/wp-content/uploads/2021/01/herbert2000.pdf 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 [https://scholar.google.co.nz/scholar?q=EMDR&hl=en&as_sdt=0%2C5&as_ylo=&as_yhi= 69,800] publications to date have mentioned EMDR. Only [https://scholar.google.co.nz/scholar?q=EMDR&hl=en&as_sdt=0%2C5&as_ylo=&as_yhi=2000 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)

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

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 ([https://en.wikipedia.org/w/index.php?title=Eye_movement_desensitization_and_reprocessing&diff=1275308724&oldid=1270879638 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)

I made several changes ([https://en.wikipedia.org/w/index.php?title=Eye_movement_desensitization_and_reprocessing&diff=1275330055&oldid=1275312360 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 ([https://en.wikipedia.org/w/index.php?title=Eye_movement_desensitization_and_reprocessing&diff=1275335406&oldid=1275331835 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)

That's really bad practice and a backward step from how it was organised previously. Bon courage (talk) 04:36, 28 May 2025 (UTC)

:That was added in {{u|Markworthen}}'s revisions, so I'm pinging him so he can answer. My impression from the edit summaries was that it was a place to put a bunch of paragraphs that didn't seem to fit where they were initially placed without completely deleting them, but I could definitely be wrong.

:I also agree that criticism sections are not ideal, FWIW. Some of that material should be reintegrated into the article but TBH a decent amount of it is from 20-25 year old sources that don't really seem to line up with newer ones. Loki (talk) 19:08, 28 May 2025 (UTC)