EMDR, Hey look over here…No quick, over here

[The Man]

Eye Movement Desensitization and Reprocessing

http://en.wikipedia.org/wiki/Eye_movement_desensitization_and_reprocessing

I never heard of this.

Anyone here experience this treatment or been helped by it?

I read a rather large article in the paper today but the Wikipedia article doesn’t paint a rosy a picture as the news article did. Apparently there doesn’t seem to be much support or actual mechanism indicating that the eye movements actually contribute to the therapy.

Any thoughts please.

 

[Joey McGee]

Most likely, any benefit comes from the same process that makes exposure therapy work.

http://en.m.wikipedia.org/wiki/Exposure_therapy

Also, the kind of distraction and confusion elicited might activate some of the mechanisms that make CBT work.

Another therapy that probably works on those mechanisms is EFT or "tapping."

 

[Skeptic Ginger]

Here's the Cochrane Review the Wiki article uses as a reference:

Psychological treatment of post-traumatic stress disorder (PTSD)

Types of studies - Any randomised controlled trial of a psychological treatment.

Types of participants - Adults suffering from traumatic stress symptoms for three months or more.

Types of interventions - Trauma-focused cognitive behavioural therapy/exposure therapy (TFCBT); stress management (SM); other therapies (supportive therapy, non-directive counselling, psychodynamic therapy and hypnotherapy); group cognitive behavioural therapy (group CBT); eye movement desensitisation and reprocessing (EMDR).

Types of outcomes - Severity of clinician rated traumatic stress symptoms. Secondary measures included self-reported traumatic stress symptoms, depressive symptoms, anxiety symptoms, adverse effects and dropouts....

... EMDR did significantly better than waitlist/usual care (SMD = -1.51; 95% CI, -1.87 to -1.15; 5 studies; n = 162). There was no significant difference between EMDR and TFCBT (SMD = 0.02; 95% CI, -0.28 to 0.31; 6 studies; n = 187). There was no significant difference between EMDR and SM (SMD = -0.35; 95% CI, -0.90 to 0.19; 2 studies; n = 53). EMDR did significantly better than other therapies (self-report) (SMD = -0.84; 95% CI, -1.21 to -0.47; 2 studies; n = 124).

Authors' conclusions

There was evidence individual TFCBT, EMDR, stress management and group TFCBT are effective in the treatment of PTSD. Other non-trauma focused psychological treatments did not reduce PTSD symptoms as significantly. There was some evidence that individual TFCBT and EMDR are superior to stress management in the treatment of PTSD at between 2 and 5 months following treatment, and also that TFCBT, EMDR and stress management were more effective than other therapies....

Plain Language Summary
This review concerns the efficacy of psychological treatment in the treatment of PTSD. There is evidence that individual trauma focused cognitive-behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), stress management and group TFCBT are effective in the treatment of PTSD. Other non-trauma focused psychological treatments did not reduce PTSD symptoms as significantly. There is some evidence that individual TFCBT and EMDR are superior to stress management in the treatment of PTSD at between 2 and 5 months following treatment, and also that TFCBT, EMDR and stress management are more effective than other therapies. There is insufficient evidence to show whether or not psychological treatment is harmful. Trauma focused cognitive behavioural therapy or eye movement desensitisation and reprocessing should be considered in individuals with PTSD. Psychological treatments can reduce symptoms of post traumatic stress disorder (PTSD). Trauma focused treatments are more effective than non-trauma focused treatments.

A search of PubMed might get one a better idea on the validity of the actual science. Cochrane Reviews are good for some things, and not perfect when it comes to other things. They would have looked at the study methodology, but the total number of subjects involved in the review of this particular therapy wasn't very big. (Three studies, n=187, 53, & 124 respectively.)

 

[Joey McGee]

There are actually several meta-analyses that say emdr is compareable to exposure therapy in effectiveness, but

Despite the treatment procedures being quite different between EMDR and traditional exposure therapy, some authors[8][33] continue to argue that the main effective component in EMDR is exposure.

An early critical review and meta-analysis that looked at the contribution of eye movement to treatment effectiveness in EMDR concluded that eye movement is not necessary to the treatment effect.[11][34] Salkovskis (2002) reported that the eye movement is irrelevant and that the effectiveness of the procedure is solely due to its having properties similar to cognitive behavioral therapies, such as desensitization and exposure.[35]
-wiki

So what's the point? I noticed emdr is popular with woo types, people who are into nlp etc. People like simple techniques and reliable formulas. I experimented with it at one point, like I did with tapping, and I realized that it was superfluous as I'd already gained the ability to deal with stuff without the gimmicks. But for some people, having a formula is reassuring, better than confronting and gaining control of their inner world methodically and rationally as exposure therapy seeks to do. That, and "many clinicians are uncomfortable performing the technique (exposure therapy) because they do not understand it or are not confident in their own ability to utilize it."

I mean if you look at the creators sales pitch for her book that contains self admistered techniques, you can tell there is virtually no difference between it and ET plus self-directed CBT.

I would say, whatever works, if it doesn't hurt, but I think it should be discouraged just because it's misleading and unnesscessary and people should strive for accuracy. Cheers

 

[Myriad]

Somewhere around the mid 90's, I apparently had an aol email address that was similar to that of a high-ranking member of the EMDRA, the EMDR Association.

The first message I received was some very cryptic meeting notes. I replied to the sender and politely explained that the message had been misdirected, and needed to be re-sent to the intended recipient.

The second message, which I received a few weeks later, congratulated me for having been appointed the head of the Publicity Committee for the EMDRA. This time I sent a reply-all (there were about 20 cc's) accepting the position, thanking the organization for the honor, and explaining that while so far my efforts at publicity had been limited to putting up a sign reading "EMDR -- Wow!!!" on my front lawn, I was eager to swing into action once they filled me in on a few details, such as what EMDR stood for. To whet their appetites for our future creative adventures, I confided: "I'm thinking, blimps blimps blimps!"

After that I did not expect to receive a third message. But, I did! This time it was an announcement of the scheduling of a committee meeting.

By then I had looked up what EMDR was, so I replied with complete specifications and a budget estimate for the "EMDR Blimp" (actually a dirigible), outfitted with 20 meter long port and starboard light bars, a high-powered audio system, and a cargo of basic humanitarian relief supplies, which would be dispatched to disaster sites to deliver aid and mass EMDR therapy. I pointed out that the blimp would inevitably be seen in television news footage, so that "EMDRA will quickly become to disasters what Goodyear is to football games." I also pointed out the deep mythic resonance of the image of lights in the sky signaling relief and comfort after times of distress: the Valkyrie, the Star of Bethlehem, the rainbow after Noah's flood, angels, the break of dawn, and so forth. I told them: "If you're willing to make the investment, this could be the greatest publicity masterstroke since Tang went into orbit."

And it would've been, too, darn it. 9/11 was only a few years later, and many's the time I imagined a parallel universe where the EMDR Blimp hovered for weeks over lower Manhattan.

Respectfully,
Myriad

 

[Joey McGee]

Nominated. After I wiped away the tears of some strange emotion

 

[TjW]

Somewhere around the mid 90's, I apparently had an aol email address that was similar to that of a high-ranking member of the EMDRA, the EMDR Association.

The first message I received was some very cryptic meeting notes. I replied to the sender and politely explained that the message had been misdirected, and needed to be re-sent to the intended recipient.

The second message, which I received a few weeks later, congratulated me for having been appointed the head of the Publicity Committee for the EMDRA. This time I sent a reply-all (there were about 20 cc's) accepting the position, thanking the organization for the honor, and explaining that while so far my efforts at publicity had been limited to putting up a sign reading "EMDR -- Wow!!!" on my front lawn, I was eager to swing into action once they filled me in on a few details, such as what EMDR stood for. To whet their appetites for our future creative adventures, I confided: "I'm thinking, blimps blimps blimps!"

After that I did not expect to receive a third message. But, I did! This time it was an announcement of the scheduling of a committee meeting.

By then I had looked up what EMDR was, so I replied with complete specifications and a budget estimate for the "EMDR Blimp" (actually a dirigible), outfitted with 20 meter long port and starboard light bars, a high-powered audio system, and a cargo of basic humanitarian relief supplies, which would be dispatched to disaster sites to deliver aid and mass EMDR therapy. I pointed out that the blimp would inevitably be seen in television news footage, so that "EMDRA will quickly become to disasters what Goodyear is to football games." I also pointed out the deep mythic resonance of the image of lights in the sky signaling relief and comfort after times of distress: the Valkyrie, the Star of Bethlehem, the rainbow after Noah's flood, angels, the break of dawn, and so forth. I told them: "If you're willing to make the investment, this could be the greatest publicity masterstroke since Tang went into orbit."

And it would've been, too, darn it. 9/11 was only a few years later, and many's the time I imagined a parallel universe where the EMDR Blimp hovered for weeks over lower Manhattan.

Respectfully,
Myriad

You didn't start advertising insurance after that, did you?

 

[The Man]

Sorry I have got back to this sooner.

Most likely, any benefit comes from the same process that makes exposure therapy work.

http://en.m.wikipedia.org/wiki/Exposure_therapy

Also, the kind of distraction and confusion elicited might activate some of the mechanisms that make CBT work.

Another therapy that probably works on those mechanisms is EFT or "tapping."

Well that was actually the first thing that came to my mind, the distraction. I even thought of “tapping” as a more motor centered distraction as opposed to visual. I wonder if there is any correlation between the type of distraction (and its effectiveness) and the type of trauma or brain areas active in reliving the trauma? Say motor cortex vs visual cortex. Sorry I’ll have to look into your link latter.

 

[The Man]

Here's the Cochrane Review the Wiki article uses as a reference:

Psychological treatment of post-traumatic stress disorder (PTSD)



A search of PubMed might get one a better idea on the validity of the actual science. Cochrane Reviews are good for some things, and not perfect when it comes to other things. They would have looked at the study methodology, but the total number of subjects involved in the review of this particular therapy wasn't very big. (Three studies, n=187, 53, & 124 respectively.)

Thanks for the references Skeptic Ginger again I'll have to look at them later.

 

[The Man]

There are actually several meta-analyses that say emdr is compareable to exposure therapy in effectiveness, but



So what's the point? I noticed emdr is popular with woo types, people who are into nlp etc. People like simple techniques and reliable formulas. I experimented with it at one point, like I did with tapping, and I realized that it was superfluous as I'd already gained the ability to deal with stuff without the gimmicks. But for some people, having a formula is reassuring, better than confronting and gaining control of their inner world methodically and rationally as exposure therapy seeks to do. That, and "many clinicians are uncomfortable performing the technique (exposure therapy) because they do not understand it or are not confident in their own ability to utilize it."

I mean if you look at the creators sales pitch for her book that contains self admistered techniques, you can tell there is virtually no difference between it and ET plus self-directed CBT.

I would say, whatever works, if it doesn't hurt, but I think it should be discouraged just because it's misleading and unnesscessary and people should strive for accuracy. Cheers

Nice input Joey McGee and I'm glad you were able to come to terms in your own way. Yeah those self –experimentation anecdotes of the author are what really set off my skeptic alarm bells. As you note whatever helps and doesn’t hurt. Placebo psychology perhaps, I think at least in part but sometimes the real medicine needs a bit of a candy coating to get it down, some misdirection and distraction while the needle gets stuck in. Though I do agree striving for accuracy and a direct approach would be preferable at least to me.

 

[The Man]

Somewhere around the mid 90's, I apparently had an aol email address that was similar to that of a high-ranking member of the EMDRA, the EMDR Association.

The first message I received was some very cryptic meeting notes. I replied to the sender and politely explained that the message had been misdirected, and needed to be re-sent to the intended recipient.

The second message, which I received a few weeks later, congratulated me for having been appointed the head of the Publicity Committee for the EMDRA. This time I sent a reply-all (there were about 20 cc's) accepting the position, thanking the organization for the honor, and explaining that while so far my efforts at publicity had been limited to putting up a sign reading "EMDR -- Wow!!!" on my front lawn, I was eager to swing into action once they filled me in on a few details, such as what EMDR stood for. To whet their appetites for our future creative adventures, I confided: "I'm thinking, blimps blimps blimps!"

After that I did not expect to receive a third message. But, I did! This time it was an announcement of the scheduling of a committee meeting.

By then I had looked up what EMDR was, so I replied with complete specifications and a budget estimate for the "EMDR Blimp" (actually a dirigible), outfitted with 20 meter long port and starboard light bars, a high-powered audio system, and a cargo of basic humanitarian relief supplies, which would be dispatched to disaster sites to deliver aid and mass EMDR therapy. I pointed out that the blimp would inevitably be seen in television news footage, so that "EMDRA will quickly become to disasters what Goodyear is to football games." I also pointed out the deep mythic resonance of the image of lights in the sky signaling relief and comfort after times of distress: the Valkyrie, the Star of Bethlehem, the rainbow after Noah's flood, angels, the break of dawn, and so forth. I told them: "If you're willing to make the investment, this could be the greatest publicity masterstroke since Tang went into orbit."

And it would've been, too, darn it. 9/11 was only a few years later, and many's the time I imagined a parallel universe where the EMDR Blimp hovered for weeks over lower Manhattan.

Respectfully,
Myriad

Holy crap, now it makes sense what they were trying to do in ‘Independence Day’ with that helicopter with the light bars on the sides. Try to give the aliens some EMDR therapy after their probably very traumatic invasion and conquest of the last planet, to help them relax. We all know how well that worked out.

 

[The Man]

Most likely, any benefit comes from the same process that makes exposure therapy work.

http://en.m.wikipedia.org/wiki/Exposure_therapy

Also, the kind of distraction and confusion elicited might activate some of the mechanisms that make CBT work.

Another therapy that probably works on those mechanisms is EFT or "tapping."

OK Exposure therapy, I’ve heard of that, facing ones fears in a safe environment. I recall a documentary I saw, must have been a decade or two ago, where they were using virtual reality as the safe environment. Walk up to a virtual ledge or see a virtual spider on your hand. Don’t know how far that particular application has progressed.

CBT, Cognitive behavioral therapy. Heck I like this, “reconceptualization” rethinking things, I’m all over that. My problem is I just can’t stop, there always seems to be another way of looking at things. Now the computer variant of CBT, that seems effective, economical and logistically more distributive. Not to mention the ‘in the privacy of your own home’ that may make some more amicable to the idea of therapy. Though the office, face to face and authoritative interaction could be just what the doctor ordered for others.

Ah, Emotional Freedom Techniques, I’ve often found myself whishing I was a person of stronger feelings but am enevtibly resigned to my own type of “Emotional Freedom”. That being said, the EFT “tapping” seems quite different than what I was thinking where the therapy subject would be “tapping” as an activity to engage the motor cortex.

 

[Joey McGee]

Evolutionary bio/psych is the basis of everything. There are evolutionary reasons these therapies work. Your inability to turn off the rumination isnt anything but a solid program that isnt finding the conditions it needs to turn off. You can engineer a solution your brain is looking for and strengthen your myelin in the right direction by developing strategies based on evo-knowledge. Thats the heart of ET and CBT. Evo psychiatry is in it's infancy but these things are based on it. Look to Nesse et al to see where this is going, twenty years when all of the competing idiots in the therapy sector accept evo-derived theories in spite of their politco-emotional disorders and you will see the glory days of cognitive therapy

 

[The Man]

Evolutionary bio/psych is the basis of everything. There are evolutionary reasons these therapies work. Your inability to turn off the rumination isnt anything but a solid program that isnt finding the conditions it needs to turn off. You can engineer a solution your brain is looking for and strengthen your myelin in the right direction by developing strategies based on evo-knowledge. Thats the heart of ET and CBT. Evo psychiatry is in it's infancy but these things are based on it. Look to Nesse et al to see where this is going, twenty years when all of the competing idiots in the therapy sector accept evo-derived theories in spite of their politco-emotional disorders and you will see the glory days of cognitive therapy

The human mind is a fascinating thing, even more so by its ability to reprogram and reconfigure itself. Naturally this can lead to problems and while not experiencing it myself I have seen, in others, how this uncontrolled “rumination” can be quite debilitating. Basically why I stated this tread to discuss these types of therapies that seek to directly influence how that looping program plays out in one’s mind and letting them give themselves the switch that turns it off or gives it some satisfactory conclusion.

 

[Joey McGee]

Well one thing about the brain's plasticity is that it has that ability close to the amygdala networks essentially meaning that you can code new high-bandwidth survival networks! Which often results in alcoholism in such folks as me. These can be altered, but for evolutionary reasons, very hard.

Same reason a kung fu master who was taught karete as a toddler will use a karete move when attacked at 93

You will succeed! On the right path for sure

The rumination is bad sometimes, when it doesn't work. It's an evolutionary gamble that often loses. This has emotional conotations for people who want to label it disorder out of spite. Lack of depth in evo understanding. Madly controversial topic

 

[Joey McGee]

As far as actually circumventing this, I think the established therapies are the best game in town. Innovate and trick the mind. Trial and error. I've got more cred than most to comment and that's still the best. Key phrase: try again.