My friend, who has dealt with a lot of depression and anxiety, has gotten himself involved in EMDR Therapy. After he told me about it, I decided to look it up and it basically makes all of my woo-woo klaxons fire at full blast in the way that’s usually only reserved for stuff like ear candling, chiropractic, and scientology.
The basic concept, as far as I understand it, is that by making someone’s eyes go back and forth, or by otherwise stimulating them in a stereo fashion (he holds onto two vibrating eggs that vibrate back and forth…I’m not making this up), traumatic events that haven’t been “processed” are somehow restimulated and then exorcised. This sounds almost exactly like the Scientology concept of “engrams,” or traumatic experiences that hang around in one’s subconscious and cause trauma until they’re confronted and neutralized, through auditing using their woo woo E-meter boxes.
What’s the straight dope here? Is this scientology masquerading in the mainstream, or is it dianetics repackaged in a less tainted terminology? Of coure he claims it’s helped him a ton already…
Who knows if the explanations of how it works are accurate or just hoohah but as your link documents, there is good evidence that it works, however it does. Various scienctific bodies have agreed to that. In addition to those provided in your link, my handy British Medical Journal Clinical Evidence Handbook (Fall '08 edition) lists EMDR in the first tier of proven therapy for PTSD - only Cognitive Behavioral Therapy has as good of evidence backing it up and only two medications even make it into the next (“likely to be beneficial”) tier.
So, no, not Scientolgy despite all your woo-woo klaxons - proven efficacy. As weird as it sounds.
EMDR is nonsense. Basically what it is is taking the cognitive behavioral interventions that have been shown to work and adding the magic finger waving to it. AFAIK there still have been no studies to show that EMDR with finger waving and CBT is superior to finger waving.
Again the evidence is that it does work. Here is what the BMJ says (I’d link but it’s behind a firewall):
Their cite: National Institute for Clinical Excellence. Post traumatic stress disorder: the management of PTSD in primary and secondary care, 2005.
Better than CBT? No. As good as CBT? Yes. Different than CBT? Maybe maybe not. But again - it works. Hentor how many seesions are required for EMDR and how many for CBT? Are there cost comparisons done that you know of?
You’re not getting it. EMDR IS CBT, along with finger waving.
EMDR was started by Francine Shapiro as a treatment for anxiety after she was walking in the woods and noticed that after moving her eyes back and forth she felt better. She turned it into a therapy that involved having a person track her finger as she moved it back and forth in front of them, while also doing the standard cognitive behavioral therapy intervention.
If you do everything that one does with typical CBT and then add on the finger waving, it’s just CBT.
It should be a tip off that it turns out that Eye Movement Desensitization and Reprocessing doesn’t require “eye movement” after all. It evolved to be either eye movement or alternate hand/shoulder/leg tapping to apparently holding vibrators in each hand. Also, it turns out that it “desensitizes” for anxiety, but also for depression, bipolar disorder, conduct disorder…
When the critical element of the method isn’t actually critical, and when the method is developed for anxiety but is ultimately not specific to any particular problem, you have to start asking some questions about the method and mechanism.
It’s a bit like coming up with a treatment for treating a headache that involves giving an aspiring and stepping on the person’s toe, and calling it toe stepping headache treatment (TSHT). If there’s no difference in the effectiveness of getting rid of a headache between apsirin and TSHT, wouldn’t you propose that the toe-stepping part was not particularly needed?
No. It does have some of the flavor of Scientology with the thousands of dollars that practitioners have to pay to be “trained” to provide it, however.
It depends entirely on what the chiropractor is claiming to fix. If they say they can help with some back or neck problems, they’re legit. But a significant percentage claim to be able to cure damn near anything. It’s given chiropractitioners a bad name.
Okay Hentor so the issue isn’t whether or not what they call EMDR works but whether or not it is just CBT with finger waving. Now not that I don’t trust your portrayal of the mechanics of EMDR but my question remains: does either accomplish the same goals in fewer sessions, or with less “at home work”, or at less cost?
Biased source #1 claims it works in fewer sessions ad with less at home work.
That source also claims that process is not equal to CBT plus. Which to me is besides the point - the point would be if the difference (even if it is only a “plus”) adds anything or not.
which implies to me that in real life the number of sessions used are about the same.
It does not seem to me that EMDR is exactly the same as CBT “plus finger waving”. It is clear that it works as effectively as CBT. It may be that it actually just amounts to a different CBT protocol. And it appears that EMDR offers the potential for the same results in fewer sessions and/or with less at home work required. I remain curious about head to head cost comparisons both including and excluding some “cost” for time of patient work at home.
A search of PsychInfo on EMDR and “cost effectiveness” or “costs and cost analysis” returns 0 results.
It is a biased source. Look for meta-analyses and any head to head comparisons between CBT and EMDR. It is just no different from CBT.
The real point is whether it is possible to take standard, empirically demonstrated techniques and put a fucking irrelevant bow on them and get people to pay a lot of money to be taught how to put a bow on regular treatments.
I don’t know why, but so be it.
No. It is a CBT protocol with an irrelevant foot stomping add on, not a “different” CBT protocol.
It may offer that, but there is no reliable evidence that it achieves that yet.
As for the patient work at home time, it is interesting to consider that some sort of cost. I suppose so, but I’ve always regarded it as desirable to have people working on things as much as possible outside of the therapy session. Just like excercising muscles, interventions “take” better the more people practice them in vivo. The idea, after all, is to have people achieve lasting change in their everyday lives, no?
Sure, there are guys who think that all problems stem from the alignment of the axis/atlas. That’s a pretty tall claim to make. However, I do believe that there is a lot to be said for problems stemming from nervous impingement due to improper alignment. I have an anterior pelvic tilt because my psoas muscle is too tight. I know how to fix it and I know that it pulls my illium in different directions on my sacrum. I don’t always fix it, but when I maintain it, my whole body feels better, from stem to stern.
:eek:
