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Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is controversial within the psychological community. It was devised by Francine Shapiro in 1987 and originally designed to alleviate the distress associated with traumatic memories such as post-traumatic stress disorder (PTSD). EMDR involves focusing on traumatic memories in a manner similar to exposure therapy 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 US National Institute of Medicine found insufficient evidence to recommend EMDR. The American Psychological Association suggests EMDR may be useful for treating adult PTSD. Treatment guidelines note EMDR effectiveness is statistically the same as trauma-focused behavioral therapy, and 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). There is debate about how the therapy works and whether it is more effective than other established treatments. The eye movements have been criticized as having no scientific basis. The founder promoted the therapy for the treatment of PTSD, and proponents employed untestable hypotheses to explain negative results in controlled studies. EMDR has been characterized as a pseudoscientific purple hat therapy (i.e., only as effective as its underlying therapeutic methods without any contribution from its distinctive add-ons). Classification and technique EMDR adds a number of non-scientific practices to exposure therapy. EMDR is classified as one of the "power therapies" alongside thought field therapy, Emotional Freedom Techniques and others – so called because these therapies are marketed as being superior to established therapies which preceded them. EMDR is typically undertaken in a series of sessions with a trained therapist. The number of sessions can vary depending on the progress made. A typical EMDR therapy session lasts from 60 to 90 minutes. Trauma and PTSD The person being treated is asked to recall an image, phrase, and emotion that represent a level of distress related to a trigger while generating one of several types of bilateral sensory input, such as side-to-side eye movements or hand tapping. The 2013 World Health Organization practice guideline says that "Like cognitive behavioral therapy (CBT) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure or (d) homework." Training Shapiro was criticized for repeatedly increasing the length and expense of training and certification, allegedly in response to the results of controlled trials that cast doubt on EMDR's efficacy. This included requiring the completion of an EMDR training program in order to be qualified to administer EMDR properly after researchers using the initial written instructions found no difference between no-eye-movement control groups and EMDR-as-written experimental groups. Further changes in training requirements and/or the definition of EMDR included requiring level II training when researchers with level I training still found no difference between eye-movement experimental groups and no-eye-movement controls and deeming "alternate forms of bilateral stimulation" (such as finger-tapping) as variants of EMDR by the time a study found no difference between EMDR and a finger-tapping control group. Such changes in definition and training for EMDR have been described as "ad hoc moves [made] when confronted by embarrassing data". Medical uses EMDR is controversial within the psychological community. It is used by some practitioners for trauma therapy and in the treatment of complex post-traumatic stress disorder. Acute stress disorder and PTSD Effectiveness A Cochrane systematic review comparing EMDR with other psychotherapies in the treatment of Chronic PTSD found EMDR to be just as effective as TF-CBT and more effective than the other non-TF-CBT psychotherapies. Caution was urged interpreting the results due to low numbers in included studies, risk of researcher bias, high drop-out rates, and overall "very low" quality of evidence for the comparisons with other psychotherapies. A 2016 systematic review and meta-analysis found that the effect size of EMDR for PTSD is comparable to other evidence-based treatments, but that the strength of evidence was of a low quality, indicating that the effect sizes achieved are associated with substantial uncertainty. Many randomized trials of EMDR have been criticized for poor control groups, small sample sizes, and other methodological flaws. It has been called a purple hat therapy because any effectiveness is provided by the underlying therapy (or the standard treatment), not from EMDR's distinctive features. There is some evidence that EMDR can be as effective as trauma focused cognitive behavioral therapy (TF-CBT) for treating PTSD, though concerns have been raised about the poor quality of the underlying studies. In a 2021 systematic review of 13 studies, clients had mixed perceptions of the effectiveness of EMDR therapy. Medical guidelines The World Health Organization's 2013 report on stress-related conditions found insufficient evidence to support EMDR for acute symptoms of traumatic stress. Its 2023 guideline for mental, neurological and substance use disorders recommended EMDR with moderate evidence for adults and children in treating PTSD. The 2018 International Society for Traumatic Stress Studies practice guidelines "strongly recommend" EMDR as an effective treatment for post-traumatic stress symptoms. As of 2017, the American Psychological Association "conditionally recommends" EMDR for the treatment of PTSD in adults, meaning its use is suggested rather than recommended. The UK National Institute for Health and Care Excellence's 2018 PTSD guidelines found low-to-very-low evidence of efficacy for EMDR in treating PTSD, but what was available justified recommending it for non combat-related trauma. A 2017 joint report from the US Departments of Veterans Affairs and Defense describes the evidence for EMDR in the treatment of PTSD as "strong." The Australian 2013 National Health and Medical Research Council guidelines recommends EMDR for the treatment of PTSD in adults with its highest grade of evidence, noting that "EMDR now includes most of the core elements of standard trauma-focussed CBT (TF-CBT)" and "the.... Discover the Eyal Rosen popular books. Find the top 100 most popular Eyal Rosen books.