A review of the most recent research suggests that although the treatment is effective, it is not because of the reasons purported to be effective by EMDR practitioners.
EMDR, which stands for Eye Movement Desensitization and Reprocessing, is a relatively new therapy that research has shown to be effective in reducing symptoms of PTSD. Briefly, EMDR works by having the patient recount the trauma experienced in detail, while moving his eyes back and forth in a clockwork like fashion. After several sessions, the patient experiences significantly less distress when talking or thinking about the trauma. EMDR is a treatment that comes with a great deal of controversy however.
Does EMDR really work? The short answer is yes… kind of. There is significant research that shows it is effective in significantly reducing symptoms of posttraumatic stress disorder in up to 78% of patients (Carlson et al., 1998). However, numerous studies comparing EMDR to another popular treatment for PTSD, called Prolonged Exposure, show virtually no differences in effectiveness. Proponents of EMDR point to limited research that shows patients with EMDR show gains a few sessions before those individuals receiving prolonged exposure. However, this is likely because the exposure protocols used in this research devoted the first 3-4 sessions to completing assessment measures and educating the patient about the rationale for the treatment. Both of these treatment components are considered a higher standard of care than immediately moving into the treatment. As such, Prolonged Exposure protocols include them as a necessary component of treatment despite their not leading to immediate symptom reduction.
Most noteworthy, are the numerous studies that compared the effects of standard EMDR, with EMDR minus the eve movement component (Davidson and Parker, 2001). What these studies found was that there was no difference whatsoever between the two treatments, suggesting there is no benefit to moving one’s eyes back and forth. Eliminating the eye movement component, you are left with a therapy in which the patient recounts their trauma narrative repeatedly during the session, a treatment identical to prolonged exposure.
The good news is that because the research shows that EMDR likely works no differently than prolonged exposure, it is still effective for the patients who receive it. The problematic piece of this, is the perpetuation of this treatment despite the identification of the superfluous components. With the increased focus on evidence-based practice, the popularity of this outdated therapy highlights the number of clinicians who are basing a large portion of their practice on interventions with no support in the research. A staggering 83% of clinicians do not use exposure therapy (Zayfert et al., 2005), which is the treatment of choice for all of the anxiety disorders. This frightening statistic underscores the importance of the need for patients to become informed consumers of science, and asking about their therapist’s methods and training prior to being seen as a patient.
Carlson, J., Chemtob, C.M., Rusnak, K., Hedlund, N.L, & Muraoka, M.Y. (1998). Eye movement desensitization and reprocessing (EMDR): Treatment for combat-related post-traumatic stress disorder. Journal of Traumatic Stress, 11, 3-24.
Davidson, P.R., & Parker, K.C.H. (2001). Eye movement desensitization and reprocessing (EMDR): A meta-analysis. Journal of Consulting and Clinical Psychology, 69, 305-316.
Zayfert, C et al. (2005). Exposure utilization and completion of cognitive behavioral therapy for PTSD in a "real world" clinical practice. Journal of Traumatic Stress, 18, 6, 637-645.
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