EMDR and the Media
Is Change in the Wind?
Since eye movement desensitization and reprocessing (EMDR) first gained popularity in the early 1990s, it has received extensive coverage in professional journals and in the popular media. Over the years, EMDR has been featured in various media outlets, including ABC News 20/20, The Boston Globe, The Los Angeles Times, National Public Radio's Morning Edition, Newsweek, The Philadelphia Inquirer, and The Washington Post, to name but a few. Although EMDR has been covered in a wide variety of outlets, the quality of this coverage has been equally variable. Widespread coverage of EMDR in the media largely began with a positive article in The Washington Post in 1994, and much subsequent coverage touted the treatment as a revolutionary breakthrough in psychotherapy (see Herbert et al., 2000 for a discussion). Anecdotal evidence was usually cited in these pieces to bolster claims from supporters that EMDR consistently produced very rapid (e.g., one-session) and at times seemingly miraculous cures of psychological distress, especially symptoms of posttraumatic stress disorder (PTSD). When reviewing this early coverage of EMDR, it is clear that skepticism and critical thinking were often in short supply. When critics were presented, they frequently were granted little more than a few lines or sound bites to voice their concerns, which were overshadowed by additional vivid and emotion-laden anecdotes of "successful" EMDR treatment.
Furthermore, at times skeptics have been almost entirely excluded from coverage. For example, EMDR was favorably featured in a story for ABC News 20/20 in 1994. Dr. James Herbert, who was the only critic interviewed for the piece, provided evidence that countered the claims made by EMDR proponents. However, his testimony was excluded from the final televised piece. Instead, 15 seconds out of the 11-minute piece was devoted to the critical viewpoint, which consisted of flashing a few critical peer-reviewed articles concerning EMDR on the screen and noting that not all psychologists agreed with validity of the anecdotal evidence presented by proponents (J. D. Herbert, personal communication, September 27, 2001).
Since the appearance of these media stories, a great deal of controlled research has been conducted on EMDR. Therefore, we can now more easily examine the claims of promoters in light of the accumulated research evidence. Fortunately, more media stories on EMDR are beginning to incorporate these findings into their analyses of EMDR. One example is a sharply critical piece on EMDR in San Francisco Weekly by Dara Colwell (2000).
More recently, an extensive review of EMDR, entitled "The Finger-Wagging Cure" by Carol Milstone (2001), appeared in the Canadian magazine Saturday Night. The article began with the presentation of the harrowing story of a coal miner who developed symptoms of posttraumatic stress after being badly injured and nearly killed in a construction equipment accident. The man reported dramatic positive changes after only a few sessions of EMDR and testifies that the treatment "released the pain" of the trauma. This is usually the point at which many previous articles on EMDR would have presented one or two token skeptics and provided additional anecdotal evidence to counter any of the criticisms. However, Milstone's article did not follow this common formula. Instead, she chose to delve more deeply into the claims of EMDR proponents to contrast these claims with the research evidence.
Milstone noted that many of the initial claims of EMDR proponents have not been supported by subsequent research. No longer is EMDR officially billed as a single-session "cure" for traumatic memories, as was originally implied by proponents. Furthermore, converging lines of evidence have demonstrated that eye movements, which are arguably the only unique feature of the treatment, are probably not responsible for any of the benefits produced by EMDR. Specifically, studies that have substituted "bilateral" eye movements with no eye movements have shown no reliable differences between groups on important outcome measures (see Herbert et al., 2000 for a review). In a recent meta-analysis of EMDR research, Davidson and Parker (2001) concurred with the aforementioned conclusions and pointed out that EMDR has not been shown to be any more efficacious than other exposure therapies for PTSD. One well-designed and independent study even demonstrated that EMDR was inferior to cognitive-behavioral therapy with exposure for treating PTSD (Devilly & Spence, 1999).
The Saturday Night article also differs from other media coverage of EMDR because it accords little credence to vivid testimonials of success and expresses skepticism regarding some of the more extreme claims of EMDR proponents. Milstone wrote that some clinicians have recently claimed that EMDR can be used to treat a diverse array of conditions, including Parkinson's disease, schizophrenia, dissociative identity disorder (formerly known as multiple personality disorder), and behavioral problems in toddlers. Nevertheless, these claims are not supported by any evidence. Reporting these unsupported claims of success allows readers to appreciate how problematic a reliance on anecdotal "evidence" can be when attempting to ascertain the validity of a treatment.
Furthermore, Milstone critically examined the theoretical rationale underlying EMDR's putative effects. The standard EMDR procedure consists of a therapist moving his or her index and middle fingers rapidly from left to right in front of the patient, who is asked to visually track the movement. The therapist periodically stops the finger-waving to check on how the patient is feeling, and the treatment is continued until relief is reported. Francine Shapiro (1995), the therapy's creator, has promoted the theory that EMDR owes its effectiveness to a process similar to that found in rapid eye movement (REM) sleep, thereby allowing traumatic memories to be processed and resolved quickly by stimulating the left and right hemispheres of the brain. However, Milstone pointed out that this theory is inconsistent with current findings in neurobiology and that the eye movements induced by the EMDR therapist are qualitatively different from the saccadic eye movements that occur naturally. This is another example of how Milstone offered ample opportunity for critics to rebut claims from EMDR supporters that are not based on solid scientific evidence.
Milstone's review of EMDR led her to be extremely skeptical of the claims of EMDR proponents. One critic who was quoted compared Shapiro to a revivalist preacher and implied that she uses rhetoric in lieu of research evidence to sway opinions. Still other critics mentioned in the article called into question Shapiro's professional qualifications. However, these issues are largely immaterial to the empirical status of EMDR and could be seen as detracting from the substance of Milstone's article.
Milstone's article will likely be criticized by many EMDR proponents. Nevertheless, this article appears to be representative of a subtle shift in the media coverage of EMDR that has been evident in recent years. No longer is EMDR consistently regarded as a breakthrough treatment. Moreover, journalists appear to be more readily acknowledging the lack of research support for many of the claims of EMDR promoters. This state of affairs can be contrasted with the more recent favorable publicity accorded in the media to the novel "energy" therapies (e.g., Thought Field Therapy), in which clients are instructed to tap on the body's "energy meridians" to gain relief from psychological distress (see previous Media Watch commentary by Lilienfeld, 2002). One hopes that those in the media will learn from their mistakes regarding EMDR so that they do not continue to become unwitting accomplices in the premature promotion of insufficiently researched therapeutic approaches.
Colwell, D. (2000, January 19). Blind faith. San Francisco Weekly. Retrieved August 4, 2002, from http://www. sfweekly.com/issues/2000-01-19/feature.html.
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.
Devilly, G. J., & Spence, S. H. (1999). The relative efficacy and treatment distress of EMDR and a cognitive behavioral trauma treatment protocol in the amelioration of post traumatic stress disorder. Journal of Anxiety Disorders, 13, 131-157.
Herbert, J. D., Lilienfeld, S. O., Lohr, J. M., Montgomery, R. W., O'Donohue, W. T., Rosen, G. M., & Tolin, D. F. (2000). Science and pseudoscience in the development of eye movement desensitization and reprocessing: Implications for clinical psychology. Clinical Psychology Review, 20, 945-971.
Lilienfeld, S. O. (2002). Philadelphia Inquirer features article on Thought Field Therapy. The Scientific Review of Mental Health Practice, 1(1), 85-86.
Milstone, C. (2001, August 18). The finger-wagging cure. Saturday Night, 116(30), 22-28.
Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic protocols, principles, and procedures. New York: Guilford Press.
A. Gaudiano, M.A.
Department of Psychology