Psycho-Babble Medication Thread 14804

Shown: posts 9 to 33 of 35. Go back in thread:

 

The usefulness of talk therapy

Posted by Bob on November 12, 1999, at 20:52:12

In reply to Re: Psychotherapy sites, posted by Adam on November 12, 1999, at 18:23:53

... for me, that is.

(btw, Adam, I can see why maybe we knock heads on occasion without me knowing it ... in some ways, we are just too much alike ;^)

Sri Chinmoy, in teaching about the "goal" of meditation, talks about expanding upward and inward at the same time. The ultimate high, the deepest insight, all at the same time. That's why, for me, meditation is therapeutic.

With my therapist, it works this way. I started with what I thought was a good understanding of the heart of my problem ... but there always were these metaphors I used to "understand" my pain without really understanding the metaphors themselves. Examining my life with my therapist has been like peeling an onion -- she challenges my perceptions and adds her own insights, and eventually (tho not gradually ... it tends to come in an epiphany or thru some critical mass) a layer gets peeled back. the metaphors take on not one but two added dimensions -- one peering in on the structure of my "self", the other peering out on how that self experiences the world. In four years, I've been able to do this three or four times. It may not seem like much progress, but each shift in understanding has been life-shaking. Quality, not quantity.

Of course, my meditation has given me one more metaphor ... something that acted as a key to the locks several of my other essential metaphors posed. One guided meditation of Sri Chinmoy's is, once you have calmed yourself in a deep meditative state, to go to your heart's door and open it to see what's there. When I went to my heart's door, I was standing on the outside. Everything outside was blacker than night, except for the pure white light (tinging my heart's door that color of red you see when you put your fingers over a flashlight) coming from inside thru a barely cracked opening of the door. Even though the door is clearly not locked, since it's open a bit, I cannot open the door. Yet. For now, I'm still on the outside of my own heart.

It may not sound all that good, but recognizing that has been a comfort ... it feels like something unknown is now much better defined.

Bob

 

Re: The usefulness of talk therapy

Posted by Adam on November 13, 1999, at 2:02:46

In reply to The usefulness of talk therapy, posted by Bob on November 12, 1999, at 20:52:12

So, all you armchair diagnosticians out there, do I sound like I have a "personality disorder"?
It has occurred to me, just because of what Elizabeth said about the appropriate use of CBT. But
does anxiety and fear learned through bad experiences constitute a "personality disorder"?
Does having a "schema" or two put one in that rather unhappy catagory? I'm not an arm slasher,
never was prone to fits of rage when someone told me I was out of line. I don't seem to be
"borderline" or "narcissistic" as far as I can tell. Avoidant? Perhaps, but avoidance is a
hallmark of OCD. I just don't know. Does it really help to know?

 

Re: The usefulness of talk therapy

Posted by Noa on November 13, 1999, at 4:45:00

In reply to Re: The usefulness of talk therapy, posted by Adam on November 13, 1999, at 2:02:46

Having a schema or two is not an indication of a personality disorder. Everyone operates under the influence of schemas. We develop beliefs and don't challenge them, and they influence our lives. THis is the basic premise of CBT. CBT challenges schemas head on, but assumes that most people can take the head on assault. I believe they are wrong about that. Some people can take the head on assault, others can't. Not being able to does not indicate a "personality" disorder.
I don't even fully accept the idea of "personality" disorders, anyway. I believe just about everyone in the world could fall under the Dx of "Personality Disorder Not Otherwise Specified".
Sure you may have avoidant tendencies--you are protecting yourself from the anxiety you experience.
Forget about the DX. Forget about a clear-cut specific form of TX. I think it is possible that these CATEGORIES are playing into your compulsive tendencies. If you are interested, talk therapy can be very useful in helping you to sort out the meaning of stuff to you in your life, to help you own yourself more and be more conscious about how you want to and are able to live your life as yourself. In terms of the brain laterality thing that I am currently preoccupied with, talk therapy helps to bring the emotional, irrational right side together with the logical verbal left, for a more peaceful coexistence.
If you seek out a therapist, go for one who is well versed in your particular symptoms, and is comfortable about a multimodal approach (medication, etc. plus talk therapy, etc.), a therapist who is knowlegable but not hung up on diagnosis ala DSM, is more interested in understanding you and your difficulties as an individual.

 

Re: The usefulness of talk therapy

Posted by Elizabeth on November 13, 1999, at 17:05:16

In reply to Re: The usefulness of talk therapy, posted by Adam on November 13, 1999, at 2:02:46

> So, all you armchair diagnosticians out there, do I sound like I have a "personality disorder"?

Goodness, I didn't mean to imply that. I've just always thought that personality disorders seemed like ideal targets for cognitive-behavioral therapy, because they are pretty much defined by maladaptive attitudes, behaviors, etc.

 

Does Personality Disorder = Character Disorder?

Posted by CarolAnn on November 13, 1999, at 21:09:58

In reply to Re: The usefulness of talk therapy, posted by Adam on November 13, 1999, at 2:02:46

I'm curious because I read once(I think in "The Road Less Traveled"by Peck) that the difference between being neurotic(Depression, OCD,ect.) and having a Character Disorder is that a Neurotic feels that their is something inherently *wrong* with the person they are, in effect blaming themselves for all their problems(ie: if mom uses verbal abuse, it must be that I am such a bad person that I deserve it). On the other hand, someone with a Character disorder, feels that there is something *wrong* with everyone else, blaming all their problems on others(ie:it's not *my* fault I can't hold down a job, it was all those stupid bosses trying to beat me down). The character disorder is so busy blaming outside sources, that they never even consider or often don't "remember" any abuse in their past. For this reason(according to the book)the Neurotic is very much easier to treat, knowing and being willing to find out, "why" they are Neurotic. Character Disorders can be almost impossible to treat, after all, how do you solve problems that someone either refuses to believe exist or problems that someone is utterly incapable of realizing the existence of? Anyway, this might be out-of-date psychology, I read the book years ago.CarolAnn

 

Re: The usefulness of talk therapy-E

Posted by Adam on November 14, 1999, at 14:03:11

In reply to Re: The usefulness of talk therapy, posted by Elizabeth on November 13, 1999, at 17:05:16

I know you didn't. I'm speculating on my own, though I agree with your oppinion that CBT (or perhaps
DBT) is ideally applied to "maladaptive attitutes, behaviors, etc." Since I have displayed those
could I fit into that catagory (personality disorder), and if so, what does it mean? I'm probably
experiencing what I have heard many "100-level" psych. students experience: As they are introduced to
the concepts of abnormal psychology, they recogize a number of symptoms in themselves and start putting
themselves with varying degrees of seriousness into inappropriate diagnostic catagories.

> > So, all you armchair diagnosticians out there, do I sound like I have a "personality disorder"?
>
> Goodness, I didn't mean to imply that. I've just always thought that personality disorders seemed like ideal targets for cognitive-behavioral therapy, because they are pretty much defined by maladaptive attitudes, behaviors, etc.

 

Re: The usefulness of talk therapy-N

Posted by Adam on November 14, 1999, at 14:04:57

In reply to Re: The usefulness of talk therapy, posted by Noa on November 13, 1999, at 4:45:00

Thank you, Noa. Extremely good advice.

> Having a schema or two is not an indication of a personality disorder. Everyone operates under the influence of schemas. We develop beliefs and don't challenge them, and they influence our lives. THis is the basic premise of CBT. CBT challenges schemas head on, but assumes that most people can take the head on assault. I believe they are wrong about that. Some people can take the head on assault, others can't. Not being able to does not indicate a "personality" disorder.
> I don't even fully accept the idea of "personality" disorders, anyway. I believe just about everyone in the world could fall under the Dx of "Personality Disorder Not Otherwise Specified".
> Sure you may have avoidant tendencies--you are protecting yourself from the anxiety you experience.
> Forget about the DX. Forget about a clear-cut specific form of TX. I think it is possible that these CATEGORIES are playing into your compulsive tendencies. If you are interested, talk therapy can be very useful in helping you to sort out the meaning of stuff to you in your life, to help you own yourself more and be more conscious about how you want to and are able to live your life as yourself. In terms of the brain laterality thing that I am currently preoccupied with, talk therapy helps to bring the emotional, irrational right side together with the logical verbal left, for a more peaceful coexistence.
> If you seek out a therapist, go for one who is well versed in your particular symptoms, and is comfortable about a multimodal approach (medication, etc. plus talk therapy, etc.), a therapist who is knowlegable but not hung up on diagnosis ala DSM, is more interested in understanding you and your difficulties as an individual.

 

Back to trauma theory

Posted by Morc on November 14, 1999, at 14:25:52

In reply to Re: The usefulness of talk therapy-N, posted by Adam on November 14, 1999, at 14:04:57


Actually, when I started this thread, I had more in mind classical trauma theory. This approach was given up, it seems to me, by mainstream psychotherapy long ago, leading to psychoanalysis, then somatic (drug) therapies in its place. But now that there are better ways to unearth and process traumas (EMDR, for one, from what I've read), is this something to look into? I guess I'm curious if others have tried this route, especially if they've unearthed some deep causative factors, etc. The point is, ideally, healing the mind-brain of the effect of past traumas, without using meds. Any takers?


 

"repression"

Posted by Elizabeth on November 14, 1999, at 14:44:00

In reply to Back to trauma theory, posted by Morc on November 14, 1999, at 14:25:52

> Actually, when I started this thread, I had more in mind classical trauma theory. This approach was given up, it seems to me, by mainstream psychotherapy long ago, leading to psychoanalysis, then somatic (drug) therapies in its place. But now that there are better ways to unearth and process traumas (EMDR, for one, from what I've read), is this something to look into? I guess I'm curious if others have tried this route, especially if they've unearthed some deep causative factors, etc. The point is, ideally, healing the mind-brain of the effect of past traumas, without using meds. Any takers?

Here's another thing to be wary of: any therapy that claims to be able to unearth repressed memories of childhood trauma. Run away.

That said, people who do remember real traumas often respond to a combination of psychotherapy and medication.

EMDR is not exactly an ineffective therapy, but it is a fraud in that its only distinctive feature (eye-hand movements) has proven to be of no value - EMDR is no more effective than standard desensitization therapy (appropriate for phobias, which can be one aspect of PTSD).

 

Re: "repression"

Posted by Morc on November 16, 1999, at 17:32:53

In reply to "repression", posted by Elizabeth on November 14, 1999, at 14:44:00


> EMDR is not exactly an ineffective therapy, but it is a fraud in that its only distinctive feature (eye-hand movements) has proven to be of no value - EMDR is no more effective than standard desensitization therapy (appropriate for phobias, which can be one aspect of PTSD).

Pretty strong statement. Have you tried it, to know from the "inside"?

 

Re: "repression"

Posted by Elizabeth on November 17, 1999, at 2:29:50

In reply to Re: "repression", posted by Morc on November 16, 1999, at 17:32:53

> Pretty strong statement. Have you tried it, to know from the "inside"?

Not necessary. I would not base my opinion of a therapy (a drug, a talking therapy, or a new-age therapy like EMDR) exclusively on my own experience of it, but on well-designed clinical studies, or in the absence of such studies, on the existence of well-documented case reports.

At this time there is no evidence that the eye-hand movement aspect of EMDR has any therpaeutic eeffect, nor is there a plausible theoretical basis for it.

 

More on EMDR

Posted by Morc on January 2, 2000, at 12:27:11

In reply to Re: "repression", posted by Elizabeth on November 17, 1999, at 2:29:50


> Not necessary. I would not base my opinion of a therapy (a drug, a talking therapy, or a new-age therapy like EMDR) exclusively on my own experience of it, but on well-designed clinical studies, or in the absence of such studies, on the existence of well-documented case reports.
>
> At this time there is no evidence that the eye-hand movement aspect of EMDR has any therpaeutic eeffect, nor is there a plausible theoretical basis for it.

Hi, Elizabeth.

Can you pass on the locations of some of those clinical studies you refer to above? I just finished reading "EMDR: The Breakthrough Therapy" by Francine Shapiro and Margot Forrest, and am feeling pretty convinced of its validity, at least enough to give it a try.


 

Ooops! To Elizabth, re EMDR, I mean

Posted by Morc on January 2, 2000, at 12:32:19

In reply to More on EMDR, posted by Morc on January 2, 2000, at 12:27:11

>
> > Not necessary. I would not base my opinion of a therapy (a drug, a talking therapy, or a new-age therapy like EMDR) exclusively on my own experience of it, but on well-designed clinical studies, or in the absence of such studies, on the existence of well-documented case reports.
> >
> > At this time there is no evidence that the eye-hand movement aspect of EMDR has any therpaeutic eeffect, nor is there a plausible theoretical basis for it.
>
> Hi, Elizabeth.
>
> Can you pass on the locations of some of those clinical studies you refer to above? I just finished reading "EMDR: The Breakthrough Therapy" by Francine Shapiro and Margot Forrest, and am feeling pretty convinced of its validity, at least enough to give it a try.

Forgot to address it!

 

Re: More on EMDR

Posted by Elizabeth on January 3, 2000, at 9:26:39

In reply to More on EMDR, posted by Morc on January 2, 2000, at 12:27:11

(This didn't go through the first time. Let's see if it works this time.)

Here are a couple of citations + abstracts (of clinical studies and reviews thereof, and responses to criticisms by EMDR advocates) that might interest you, in reverse chronological order. (Most of the full-text articles aren't available online, AFAIK.)

J Anxiety Disord 1999 Jan-Apr;13(1-2):209-23
Traumatic memories, eye movements, phobia, and panic: a critical note on the proliferation of EMDR.
Muris P, Merckelbach H
Department of Psychology, Maastricht University, The Netherlands. p.muris@psychology.unimaas.nl

In the past years, Eye Movement Desensitization and Reprocessing (EMDR) has become increasingly popular as a treatment method for Posttraumatic Stress Disorder (PTSD). The current article critically evaluates three recurring assumptions in EMDR literature: (a) the notion that traumatic memories are fixed and stable and that flashbacks are accurate reproductions of the traumatic incident; (b) the idea that eye movements, or other lateralized rhythmic behaviors have an inhibitory effect on emotional memories; and (c) the assumption that EMDR is not only effective in treating PTSD, but can also be successfully applied to other psychopathological conditions. There is little support for any of these three assumptions. Meanwhile, the expansion of the theoretical underpinnings of EMDR in the absence of a sound empirical basis casts doubts on the massive proliferation of this treatment method.


J Anxiety Disord 1999 Jan-Apr;13(1-2):185-207
Eye Movement Desensitization and Reprocessing: an analysis of specific versus nonspecific treatment factors.
Lohr JM, Lilienfeld SO, Tolin DF, Herbert JD
Department of Psychology, University of Arkansas, Fayetteville 72701, USA. jlohr@comp.uark.edu

Incremental validity and incremental efficacy have become important issues in the evaluation of psychological assessment and intervention procedures. Incremental validity in assessment is that shown by novel measures over and above established ones. Incremental efficacy is that shown by novel treatments over and above nonspecific and established treatment effects. In this paper, we critically examine the question of whether Eye Movement Desensitization and Reprocessing (EMDR) possesses efficacy above and beyond nonspecific treatment effects and components that are shared with well-established interventions. A review of recently published efficacy studies reveals that (a) the effects of EMDR are largely limited to verbal report indices, (b) eye movements and other movements appear to be unnecessary, and (c) reported effects are consistent with nonspecific treatment features. Examination of individual studies shows that control procedures for nonspecific features have been minimal. We analyze EMDR for nonspecific treatment features and suggest experimental controls to examine the incremental efficacy of EMDR.


J Anxiety Disord 1999 Jan-Apr;13(1-2):173-84
Treatment fidelity and research on Eye Movement Desensitization and Reprocessing (EMDR).
Rosen GM
grosen@u.washington.edu

Eye Movement Desensitization and Reprocessing was introduced by Frances Shapiro (1989) as a treatment for posttraumatic stress disorder. When controlled studies failed to support the extraordinarily positive findings and claims made by Shapiro, proponents of EMDR raised the issue of treatment fidelity and criticized researchers for being inadequately trained. This paper considers the issues raised by EMDR proponents. It is concluded that treatment fidelity has been used as a specious, distracting issue that permits the continued promotion of EMDR in the face of negative empirical findings. Clinical psychologists are urged to remember the basic tenets of science when evaluating extraordinary claims made for novel techniques.


J Anxiety Disord 1999 Jan-Apr;13(1-2):131-57
The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder.
Devilly GJ, Spence SH
Department of Psychology, University of Queensland, Australia. dev@psy.uq.edu.au

The growing body of research into treatment efficacy with Posttraumatic Stress Disorder (PTSD) has, by-and-large, been limited to evaluating treatment components or comparing a specific treatment against wait-list controls. This has led to two forms of treatment, Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive-Behavior Therapy (CBT), vying for supremacy without a controlled study actually comparing them. The present research compared EMDR and a CBT variant (Trauma Treatment Protocol; TTP) in the treatment of PTSD, via a controlled clinical study using therapists trained in both procedures. It was found that TTP was both statistically and clinically more effective in reducing pathology related to PTSD and that this superiority was maintained and, in fact, became more evident by 3-month follow-up. These results are discussed in terms of past research. Directions for future research are suggested.


J Anxiety Disord 1999 Jan-Apr;13(1-2):101-18
The contributions of eye movements to the efficacy of brief exposure treatment for reducing fear of public speaking.
Carrigan MH, Levis DJ
State University of New York at Binghamton, USA.

The present study was designed to isolate the effects of the eye-movement component of the Eye Movement Desensitization and Reprocessing (EMDR) procedure in the treatment of fear of public speaking. Seventy-one undergraduate psychology students who responded in a fearful manner on the Fear Survey Schedule II and on a standardized, self-report measure of public speaking anxiety (Personal Report of Confidence as a Speaker; PRCS) were randomly assigned to one of four groups in a 2x2 factorial design. The two independent variables assessed were treatment condition (imagery plus eye movements vs. imagery alone) and type of imagery (fear-relevant vs. relaxing). Dependent variables assessed were self-reported and physiological anxiety during exposure and behavioral indices of anxiety while giving a speech. Although process measures indicated exposure to fear-relevant imagery increased anxiety during the procedure, no significant differences among groups were found on any of the outcome measures, except that participants who received eye movements were less likely to give a speech posttreatment than participants who did not receive eye movements. Addition of the eye movements to the experimental procedure did not result in enhancement of fear reduction. It was concluded, consistent with the results of past research, that previously reported positive effects of the EMDR procedure may be largely due to exposure to conditioned stimuli.


J Anxiety Disord 1999 Jan-Apr;13(1-2):87-99
The cognitive dismantling of Eye Movement Desensitization and Reprocessing (EMDR) treatment of Posttraumatic Stress Disorder (PTSD).
Cusack K, Spates CR
Western Michigan University, Kalamazoo, Michigan 49008, USA.

Twenty-seven subjects were exposed to standard Eye Movement Desensitization and Reprocessing (EMDR) treatment or a similar treatment without the explicit cognitive elements found in EMDR. Standardized psychometric assessments were administered (Structured Interview for Post Traumatic Stress Disorder, Impact of Event Scale, Revised Symptom Checklist-90) by independent assessors at pretest, posttest and two separate follow-up periods. Potential subjects met specific inclusion/exclusion criteria. Subjective measures including Subjective Units of Disturbance and Validity of Cognition assessments were also conducted. A two-factor repeated measures analysis of variance revealed that both treatments produced significant symptom reductions and were comparable on all dependent measures across assessment phases. The present findings are discussed in light of previous dismantling research that converges to suggest that several elements in the EMDR protocol may be superfluous in terms of the contribution to treatment outcome. These same elements have nevertheless entered unparsimoniously into consideration as possible explanatory variables.


J Anxiety Disord 1999 Jan-Apr;13(1-2):5-33
Does EMDR work? And if so, why?: a critical review of controlled outcome and dismantling research.
Cahill SP, Carrigan MH, Frueh BC
National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston 29425-0742, USA. cahillsp@musc.edu

Research on Eye Movement Desensitization and Reprocessing therapy (EMDR) was reviewed to answer the questions "Does EMDR work?" and "If so, Why?" This first question was further subdivided on the basis of the control group: (a) no-treatment (or wait list control), (b) nonvalidated treatments, and (c) other validated treatments. The evidence supports the following general conclusions: First, EMDR appears to be effective in reducing at least some indices of distress relative to no-treatment in a number of anxiety conditions, including posttraumatic stress disorder, panic disorder, and public-speaking anxiety. Second, EMDR appears at least as effective or more effective than several nonvalidated treatments (e.g., relaxation, active listening) for posttraumatic stress reactions. Third, despite statements implying the contrary, no previously published study has directly compared EMDR with an independently validated treatment for posttraumatic stress disorder (e.g., therapist-directed flooding). In the treatment of simple phobia, participant modeling has been found to be more effective than EMDR. Fourth, our review of dismantling studies reveals there is no convincing evidence that eye movements significantly contribute to treatment outcome. Recommendations regarding further research directions are provided.


J Consult Clin Psychol 1998 Feb;66(1):193-8
Treating phobic children: effects of EMDR versus exposure.
Muris P, Merckelbach H, Holdrinet I, Sijsenaar M
Department of Psychology, Universiteit Maastricht, The Netherlands. P.Muris@Psychology.unimaas.nl

This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. Twenty-six spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n = 9), (b) an exposure in vivo group (n = 9), or (c) a computerized exposure (control) group (n = 8). During the 2nd phase, all groups received a 1.5-hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5-hr exposure in vivo session produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignificant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia.


Int J Eat Disord 1998 Jan;23(1):1-5
Eye movement desensitization and reprocessing in eating disorders: caution against premature acceptance.
Hudson JI, Chase EA, Pope HG Jr
Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts 02178, USA.

OBJECTIVE: Eye movement desensitization and reprocessing (EMDR) has been claimed effective in the treatment of a wide variety of psychiatric disorders, including eating disorders. An informal survey suggests that EMDR is now widely offered to patients with eating disorders. Before accepting a new therapy such as EMDR, one must determine that its benefits outweigh its adverse effects. This paper reviews the literature in an attempt to assess the benefits and risks of the use of EMDR in the treatment of eating disorders. METHOD: We reviewed the literature on the use of EMDR to treat eating disorders and other conditions. RESULTS: Looking at the question of its benefits, we were unable to find any methodologically sound studies that have shown efficacy for EMDR in eating disorders, or, indeed, any psychiatric disorder. We were also unable to find a sound theoretical basis for expecting EMDR to be effective. In addition, EMDR may have adverse effects. First, EMDR is sometimes used in conjunction with efforts to "recover" memories of traumatic events. But "recovered memory" therapy may carry a risk of inducing potentially harmful false memories. Second, use of EMDR may prevent or delay other therapies of established efficacy for eating disorders, such as cognitive behavioral therapy and antidepressants. DISCUSSION: In light of the findings of our review, the risk/benefit ratio of EMDR does not as yet encourage its widespread acceptance.


J Consult Clin Psychol 1997 Dec;65(6):1026-35
Eye movement desensitization and reprocessing treatment for panic disorder: a controlled outcome and partial dismantling study.
Feske U, Goldstein AJ
Agoraphobia and Anxiety Treatment Center, Bala Cynwyd, Pennsylvania, USA.

Forty-three outpatients with DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed., revised; American Psychiatric Association, 1987) panic disorder were randomly assigned to receive 6 sessions of eye movement desensitization and reprocessing (EMDR), the same treatment but omitting the eye movement, or to a waiting list. Posttest comparisons showed EMDR to be more effective in alleviating panic and panic-related symptoms than the waiting-list procedure. Compared with the same treatment without the eye movement, EMDR led to greater improvement on 2 of 5 primary outcome measures at posttest. However, EMDR's advantages had dissipated 3 months after treatment, thereby failing to firmly support the usefulness of the eye movement component in EMDR treatment for panic disorder.


Br J Psychiatry 1997 Jul;171:82-6
Eye movement desensitisation and reprocessing versus exposure in vivo. A single-session crossover study of spider-phobic children.
Muris P, Merckelbach H, Van Haaften H, Mayer B
Department of Psychology, University of Maastricht, The Netherlands.

BACKGROUND: Eye movement desensitisation and reprocessing (EMDR) is a relatively new therapeutic technique that has been proposed as a treatment for post-traumatic stress disorder and other anxiety complaints. METHOD: We compared the efficacy of EMDR with that of exposure in vivo in the treatment of a specific phobia. Twenty-two spider-phobic children who met the DSM-III-R criteria for specific phobia participated in the study. Children were treated with one session of exposure in vivo and one session of EMDR in a crossover design. Treatment outcome was evaluated by self-report measures, a behavioural avoidance test and a physiological index (skin conductance level). RESULTS: Results showed positive effects of EMDR, but also suggest that it is especially self-report measures that are sensitive to EMDR. Improvement on a behavioural measure was less pronounced, and exposure in vivo was found to be superior in reducing avoidance behaviour. With regard to skin conductance level, EMDR and exposure in vivo did not differ. CONCLUSIONS: EMDR has no additional value in treatment of this type of animal phobia, for which exposure in vivo is the treatment of choice.


Compr Psychiatry 1997 Sep-Oct;38(5):300-3
Flooding versus eye movement desensitization and reprocessing therapy: relative efficacy has yet to be investigated--comment on Pitman et al (1996).
Cahill SP, Frueh BC
State University of New York, Binghamton, USA.

Pitman et al. recently published a pair of studies on the relationship between indicators of emotional processing and outcome in flooding therapy (Compr Psychiatry 1996;37:409-416) and eye movement desensitization and reprocessing therapy (EMDR; Compr Psychiatry 1996;37:419-429). Among their conclusions, they asserted EMDR was found to be at least as effective flooding in the treatment of combat-related posttraumatic stress disorder (PTSD) and produced fewer adverse consequences. Although this research constitutes an important contribution to the literature on psychosocial treatments for PTSD, their conclusions regarding the relative effectiveness of these two treatments are unwarranted. The bases of our objections are that (1) assignment of participants to treatment conditions was nonrandom, and (2) several significant procedural differences existed between the two studies in addition to the specific treatments under investigation. These include different inclusion and exclusion criteria, the confounding of psychological treatment with psychiatric medication status, and differences in assessment procedures. Since the two treatments were not compared in a single head-to-head controlled trial, we conclude that their relative efficacy has yet to be investigated.


J Behav Ther Exp Psychiatry 1996 Sep;27(3):231-9
Measuring effectiveness of eye movement desensitization and reprocessing (EMDR) in non-clinical anxiety: a multi-subject, yoked-control design.
Dunn TM, Schwartz M, Hatfield RW, Wiegele M
Department of Psychology, University of Cincinnati, OH 45221-0376, USA.

Twenty-eight subjects from a university's subject pool were paired on sex, age, severity, and type of stressful or traumatic incident. One subject in each pair was selected to receive EMDR; the experimental partner spent the same amount of time receiving a visual (non-movement) placebo. Subjective units of discomfort (SUD) scores and physiological measurements were taken prior to and following treatment. Analysis of physiological measurements and self-reported levels of stress were performed within and between each group. While the EMDR group showed significant reductions of stress, EMDR was no better than a placebo. This suggests EMDR's specific intervention involving eye movement may not be a necessary component of the treatment protocol.


J Behav Ther Exp Psychiatry 1995 Dec;26(4):285-302
The empirical status of the clinical application of eye movement desensitization and reprocessing.
Lohr JM, Kleinknecht RA, Tolin DF, Barrett RH
Department of Psychology, University of Arkansas, Fayetteville 72701, USA.

The published reports of the clinical application of eye movement desensitization and reprocessing (EMDR) are reviewed in terms of empirical validity. Case studies, single-subject experiments and group design experiments on clinical problems are evaluated for the effectiveness of the protocol, component effects, comparative effects and treatment fidelity. Classification of disorders and measurement issues are addressed. The protocol frequently reduces verbal report and independent observer ratings of distress--strikingly in some instances. Psychophysiologic measures show little effect of treatment. There is little empirical evidence to indicate the effect of treatment on motoric or behavioral indices. Eye movements do not appear to be an essential component of treatment, and there have been no substantial comparisons with other treatments. No studies have adequately controlled for nonspecific (placebo) effects of treatment. Suggestions are made for applying improved methodological controls for future applications of EMDR to clinical disorders.

 

Re: More on EMDR

Posted by Morc on January 3, 2000, at 11:12:37

In reply to Re: More on EMDR, posted by Elizabeth on January 3, 2000, at 9:26:39


Wow! Thanks! That's a lot to chew on. If I take the plunge, I'll probably report in, for a first-person account. Nice work!

 

Re: More on EMDR

Posted by Steve on January 7, 2000, at 17:47:52

In reply to Re: More on EMDR, posted by Elizabeth on January 3, 2000, at 9:26:39

Behold the power of the placebo.

> (This didn't go through the first time. Let's see if it works this time.)
>
> Here are a couple of citations + abstracts (of clinical studies and reviews thereof, and responses to criticisms by EMDR advocates) that might interest you, in reverse chronological order. (Most of the full-text articles aren't available online, AFAIK.)
>
> J Anxiety Disord 1999 Jan-Apr;13(1-2):209-23
> Traumatic memories, eye movements, phobia, and panic: a critical note on the proliferation of EMDR.
> Muris P, Merckelbach H
> Department of Psychology, Maastricht University, The Netherlands. p.muris@psychology.unimaas.nl
>
> In the past years, Eye Movement Desensitization and Reprocessing (EMDR) has become increasingly popular as a treatment method for Posttraumatic Stress Disorder (PTSD). The current article critically evaluates three recurring assumptions in EMDR literature: (a) the notion that traumatic memories are fixed and stable and that flashbacks are accurate reproductions of the traumatic incident; (b) the idea that eye movements, or other lateralized rhythmic behaviors have an inhibitory effect on emotional memories; and (c) the assumption that EMDR is not only effective in treating PTSD, but can also be successfully applied to other psychopathological conditions. There is little support for any of these three assumptions. Meanwhile, the expansion of the theoretical underpinnings of EMDR in the absence of a sound empirical basis casts doubts on the massive proliferation of this treatment method.
>
>
> J Anxiety Disord 1999 Jan-Apr;13(1-2):185-207
> Eye Movement Desensitization and Reprocessing: an analysis of specific versus nonspecific treatment factors.
> Lohr JM, Lilienfeld SO, Tolin DF, Herbert JD
> Department of Psychology, University of Arkansas, Fayetteville 72701, USA. jlohr@comp.uark.edu
>
> Incremental validity and incremental efficacy have become important issues in the evaluation of psychological assessment and intervention procedures. Incremental validity in assessment is that shown by novel measures over and above established ones. Incremental efficacy is that shown by novel treatments over and above nonspecific and established treatment effects. In this paper, we critically examine the question of whether Eye Movement Desensitization and Reprocessing (EMDR) possesses efficacy above and beyond nonspecific treatment effects and components that are shared with well-established interventions. A review of recently published efficacy studies reveals that (a) the effects of EMDR are largely limited to verbal report indices, (b) eye movements and other movements appear to be unnecessary, and (c) reported effects are consistent with nonspecific treatment features. Examination of individual studies shows that control procedures for nonspecific features have been minimal. We analyze EMDR for nonspecific treatment features and suggest experimental controls to examine the incremental efficacy of EMDR.
>
>
> J Anxiety Disord 1999 Jan-Apr;13(1-2):173-84
> Treatment fidelity and research on Eye Movement Desensitization and Reprocessing (EMDR).
> Rosen GM
> grosen@u.washington.edu
>
> Eye Movement Desensitization and Reprocessing was introduced by Frances Shapiro (1989) as a treatment for posttraumatic stress disorder. When controlled studies failed to support the extraordinarily positive findings and claims made by Shapiro, proponents of EMDR raised the issue of treatment fidelity and criticized researchers for being inadequately trained. This paper considers the issues raised by EMDR proponents. It is concluded that treatment fidelity has been used as a specious, distracting issue that permits the continued promotion of EMDR in the face of negative empirical findings. Clinical psychologists are urged to remember the basic tenets of science when evaluating extraordinary claims made for novel techniques.
>
>
> J Anxiety Disord 1999 Jan-Apr;13(1-2):131-57
> The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder.
> Devilly GJ, Spence SH
> Department of Psychology, University of Queensland, Australia. dev@psy.uq.edu.au
>
> The growing body of research into treatment efficacy with Posttraumatic Stress Disorder (PTSD) has, by-and-large, been limited to evaluating treatment components or comparing a specific treatment against wait-list controls. This has led to two forms of treatment, Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive-Behavior Therapy (CBT), vying for supremacy without a controlled study actually comparing them. The present research compared EMDR and a CBT variant (Trauma Treatment Protocol; TTP) in the treatment of PTSD, via a controlled clinical study using therapists trained in both procedures. It was found that TTP was both statistically and clinically more effective in reducing pathology related to PTSD and that this superiority was maintained and, in fact, became more evident by 3-month follow-up. These results are discussed in terms of past research. Directions for future research are suggested.
>
>
> J Anxiety Disord 1999 Jan-Apr;13(1-2):101-18
> The contributions of eye movements to the efficacy of brief exposure treatment for reducing fear of public speaking.
> Carrigan MH, Levis DJ
> State University of New York at Binghamton, USA.
>
> The present study was designed to isolate the effects of the eye-movement component of the Eye Movement Desensitization and Reprocessing (EMDR) procedure in the treatment of fear of public speaking. Seventy-one undergraduate psychology students who responded in a fearful manner on the Fear Survey Schedule II and on a standardized, self-report measure of public speaking anxiety (Personal Report of Confidence as a Speaker; PRCS) were randomly assigned to one of four groups in a 2x2 factorial design. The two independent variables assessed were treatment condition (imagery plus eye movements vs. imagery alone) and type of imagery (fear-relevant vs. relaxing). Dependent variables assessed were self-reported and physiological anxiety during exposure and behavioral indices of anxiety while giving a speech. Although process measures indicated exposure to fear-relevant imagery increased anxiety during the procedure, no significant differences among groups were found on any of the outcome measures, except that participants who received eye movements were less likely to give a speech posttreatment than participants who did not receive eye movements. Addition of the eye movements to the experimental procedure did not result in enhancement of fear reduction. It was concluded, consistent with the results of past research, that previously reported positive effects of the EMDR procedure may be largely due to exposure to conditioned stimuli.
>
>
> J Anxiety Disord 1999 Jan-Apr;13(1-2):87-99
> The cognitive dismantling of Eye Movement Desensitization and Reprocessing (EMDR) treatment of Posttraumatic Stress Disorder (PTSD).
> Cusack K, Spates CR
> Western Michigan University, Kalamazoo, Michigan 49008, USA.
>
> Twenty-seven subjects were exposed to standard Eye Movement Desensitization and Reprocessing (EMDR) treatment or a similar treatment without the explicit cognitive elements found in EMDR. Standardized psychometric assessments were administered (Structured Interview for Post Traumatic Stress Disorder, Impact of Event Scale, Revised Symptom Checklist-90) by independent assessors at pretest, posttest and two separate follow-up periods. Potential subjects met specific inclusion/exclusion criteria. Subjective measures including Subjective Units of Disturbance and Validity of Cognition assessments were also conducted. A two-factor repeated measures analysis of variance revealed that both treatments produced significant symptom reductions and were comparable on all dependent measures across assessment phases. The present findings are discussed in light of previous dismantling research that converges to suggest that several elements in the EMDR protocol may be superfluous in terms of the contribution to treatment outcome. These same elements have nevertheless entered unparsimoniously into consideration as possible explanatory variables.
>
>
> J Anxiety Disord 1999 Jan-Apr;13(1-2):5-33
> Does EMDR work? And if so, why?: a critical review of controlled outcome and dismantling research.
> Cahill SP, Carrigan MH, Frueh BC
> National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston 29425-0742, USA. cahillsp@musc.edu
>
> Research on Eye Movement Desensitization and Reprocessing therapy (EMDR) was reviewed to answer the questions "Does EMDR work?" and "If so, Why?" This first question was further subdivided on the basis of the control group: (a) no-treatment (or wait list control), (b) nonvalidated treatments, and (c) other validated treatments. The evidence supports the following general conclusions: First, EMDR appears to be effective in reducing at least some indices of distress relative to no-treatment in a number of anxiety conditions, including posttraumatic stress disorder, panic disorder, and public-speaking anxiety. Second, EMDR appears at least as effective or more effective than several nonvalidated treatments (e.g., relaxation, active listening) for posttraumatic stress reactions. Third, despite statements implying the contrary, no previously published study has directly compared EMDR with an independently validated treatment for posttraumatic stress disorder (e.g., therapist-directed flooding). In the treatment of simple phobia, participant modeling has been found to be more effective than EMDR. Fourth, our review of dismantling studies reveals there is no convincing evidence that eye movements significantly contribute to treatment outcome. Recommendations regarding further research directions are provided.
>
>
> J Consult Clin Psychol 1998 Feb;66(1):193-8
> Treating phobic children: effects of EMDR versus exposure.
> Muris P, Merckelbach H, Holdrinet I, Sijsenaar M
> Department of Psychology, Universiteit Maastricht, The Netherlands. P.Muris@Psychology.unimaas.nl
>
> This study examined the efficacy of eye movement desensitization and reprocessing (EMDR) and exposure in the treatment of a specific phobia. Twenty-six spider phobic children were treated during 2 treatment phases. During the first phase, which lasted 2.5 hr, children were randomly assigned to either (a) an EMDR group (n = 9), (b) an exposure in vivo group (n = 9), or (c) a computerized exposure (control) group (n = 8). During the 2nd phase, all groups received a 1.5-hr session of exposure in vivo. Therapy outcome measures (i.e., self-reported fear and behavioral avoidance) were obtained before treatment, after Treatment Phase 1, and after Treatment Phase 2. Results showed that the 2.5-hr exposure in vivo session produced significant improvement on all outcome measures. In contrast, EMDR yielded a significant improvement on only self-reported spider fear. Computerized exposure produced nonsignificant improvement. Furthermore, no evidence was found to suggest that EMDR potentiates the efficacy of a subsequent exposure in vivo treatment. Exposure in vivo remains the treatment of choice for childhood spider phobia.
>
>
> Int J Eat Disord 1998 Jan;23(1):1-5
> Eye movement desensitization and reprocessing in eating disorders: caution against premature acceptance.
> Hudson JI, Chase EA, Pope HG Jr
> Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts 02178, USA.
>
> OBJECTIVE: Eye movement desensitization and reprocessing (EMDR) has been claimed effective in the treatment of a wide variety of psychiatric disorders, including eating disorders. An informal survey suggests that EMDR is now widely offered to patients with eating disorders. Before accepting a new therapy such as EMDR, one must determine that its benefits outweigh its adverse effects. This paper reviews the literature in an attempt to assess the benefits and risks of the use of EMDR in the treatment of eating disorders. METHOD: We revi

 

Re: More on EMDR - the full story

Posted by Ricky Greenwald on January 27, 2000, at 19:41:32

In reply to Re: More on EMDR, posted by Steve on January 7, 2000, at 17:47:52

> Behold the power of the placebo.

I would say, "Behold the power of a smear campaign."

The numerous articles cited a few posts ago give a very misleading picture of the research on EMDR. There is a relatively small group of people who seem dedicated to trashing EMDR, and they are responsible for most of the articles cited.

On the other hand, EMDR has more controlled research supporting its use than any other psychotherapy method used to treat trauma, including direct comparisons to other credible treatments. When EMDR is used properly it consistently comes out either equal or superior.

EMDR's efficacy has been recognized by the American Psychological Association's Committee on Empirically Validated Methods, and by the International Society for Traumatic Stress Studies' Treatment Guidelines project. EMDR is used by the Red Cross, the FBI, The VA (some programs anyway) etc.

A convincing role has not yet been demonstrated for eye movements. However, all the component analysis studies have been too small to detect anything but a relatively large effect, so if eye movements play a modest role along with other treatment components, this might not show up in the studies that have been conducted to date. So the jury's still out on what (if any) the role of eye movements might be. It should also be noted that EMDR is not just a typical exposure session with eye movements thrown in; it's a rather sophisticated package of treatment components which separately have recognized effectiveness and together seem to do even better.

So please, if you're trying to inform people about EMDR, yes there are still many questions about it, but the smear campaign is getting old and is unsupportable. Since EMDR has helped so many people and since this has been documented in controlled studies again and again, it's time to start focusing on how and why it works.

 

Re: More on EMDR - the full story

Posted by dj on January 28, 2000, at 0:01:15

In reply to Re: More on EMDR - the full story, posted by Ricky Greenwald on January 27, 2000, at 19:41:32

Rickkkeeeee,

Check with Lucieeee & then show some credible references & then maybe folks MIGHT take your hype seriously. I know little about EMDR but the little I've seen indicates it has about as much credibility as Anthony Robbins, who's only effective at promoting AR.

> On the other hand, EMDR has more controlled research supporting its use than any other psychotherapy method used to treat trauma, including direct comparisons to other credible treatments. When EMDR is used properly it consistently comes out either equal or superior.
>
> EMDR's efficacy has been recognized by the American Psychological Association's Committee on Empirically Validated Methods, and by the International Society for Traumatic Stress Studies' Treatment Guidelines project. EMDR is used by the Red Cross, the FBI, The VA (some programs anyway) etc.
>

 

Re: More on EMDR - the full story

Posted by Ricky Greenwald on February 10, 2000, at 1:05:44

In reply to Re: More on EMDR - the full story, posted by dj on January 28, 2000, at 0:01:15

> Rickkkeeeee,
>
> Check with Lucieeee & then show some credible references & then maybe folks MIGHT take your hype seriously. I know little about EMDR but the little I've seen indicates it has about as much credibility as Anthony Robbins, who's only effective at promoting AR.

Maybe I'm just being prickly, but why is a straightforward assertion of fact called "hype"???

I don't have the time or interest to post every study in which EMDR looks good; there are many. However, here are a few review articles, along with my own synopsis of EMDR-relevant content (don't have them with me so I can't provide abstracts).

Chambless, D.L, Baker, M., Baucom, D., Beutler, L., Calhoun, K., Crits-Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D., Bennett Johnson, S., McCurry, S., Mueser, K., Pope, K., Sanderson, W., Shoham, V., Stickle, T., Williams, D. & Woody, S. (1998). Update on empirically validated therapies, II. The Clinical Psychologist, 51, 3-16.
This is the one by the APA committee on empirically validated therapies. EMDR earned the second-highest ranking for ptsd treatment; no treatment for ptsd was ranked higher.

Chemtob, C. M., & Pitman, R. K. (1999, November). EMDR and other neoteric approaches to the treatment of PTSD. In E. Foa (Chair), Treatment Guidelines I. Symposium conducted at the annual meeting of the International Society for Traumatic Stress Studies, Miami.
This recent conference presentation will constitute one of the chapters in the ISTSS Treatment Guidelines to be published this year. EMDR was given an "A/B" rating (the highest being a straight A) despite having much more supportive documentation than other "A" rated treatments. My understanding is that this modest understatement was a concession to the continuing discomfort some people have with the idea of EMDR.

Greenwald, R. (1996a). The information gap in the EMDR controversy. Professional Psychology: Research and Practice, 27, 67-72.
This review highlights many of the limitations in published studies on EMDR, in particular noting that poor and/or questionable treatment fidelity is associated with worse results, and vice versa.

van Etten, M., & Taylor, S. (1998). Comparative efficacy of treatments for posttraumatic stress disorder: A meta-analysis. Clinical Psychology and Psychotherapy, 5, 126-145.
This review found EMDR approximately equal in effect to cognitive-behavioral interventions, superior for some aspects of ptsd symptoms, and more rapid.

 

Re: More on EMDR - What is the evidence

Posted by Christopher Lee on February 10, 2000, at 5:06:25

In reply to Re: More on EMDR - the full story, posted by Ricky Greenwald on February 10, 2000, at 1:05:44

> I don't have the time or interest to post every study in which EMDR looks good; there are many. However, here are a few review articles, along with my own synopsis of EMDR-relevant content (don't have them with me so I can't provide abstracts).
>
> Chambless, D.L, Baker, M., Baucom, D., Beutler, L., Calhoun, K., Crits-Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D., Bennett Johnson, S., McCurry, S., Mueser, K., Pope, K., Sanderson, W., Shoham, V., Stickle, T., Williams, D. & Woody, S. (1998). Update on empirically validated therapies, II. The Clinical Psychologist, 51, 3-16.
> This is the one by the APA committee on empirically validated therapies. EMDR earned the second-highest ranking for ptsd treatment; no treatment for ptsd was ranked higher.
>
> Chemtob, C. M., & Pitman, R. K. (1999, November). EMDR and other neoteric approaches to the treatment of PTSD. In E. Foa (Chair), Treatment Guidelines I. Symposium conducted at the annual meeting of the International Society for Traumatic Stress Studies, Miami.
> This recent conference presentation will constitute one of the chapters in the ISTSS Treatment Guidelines to be published this year. EMDR was given an "A/B" rating (the highest being a straight A) despite having much more supportive documentation than other "A" rated treatments. My understanding is that this modest understatement was a concession to the continuing discomfort some people have with the idea of EMDR.
>
> Greenwald, R. (1996a). The information gap in the EMDR controversy. Professional Psychology: Research and Practice, 27, 67-72.
> This review highlights many of the limitations in published studies on EMDR, in particular noting that poor and/or questionable treatment fidelity is associated with worse results, and vice versa.
>
> van Etten, M., & Taylor, S. (1998). Comparative efficacy of treatments for posttraumatic stress disorder: A meta-analysis. Clinical Psychology and Psychotherapy, 5, 126-145.
> This review found EMDR approximately equal in effect to cognitive-behavioral interventions, superior for some aspects of ptsd symptoms, and more rapid.

The above is a quick introduction into important EMDR articles it is my intention to provide some more detail for those readers who are interested.


Overview
Recent studies have shown that EMDR is superior to alternative treatments for civilian general trauma (Marcus et al., 1997; Sheck et al., 1998) and for Vietnam Veterans (Carlson et al., 1998). In a recent meta-analysis, EMDR was reported to be the most efficient treatment for PTSD (Van Etten and Taylor, 1998). Proponents of other therapies have also published studies demonstrating the effectiveness of EMDR (Rothbaum, 1997). Wilson et al. (1996) found that EMDR was more effective than an exposure control. Furthermore the significant advantage was not just on self-report measures but also for physiological measures such as GSR, heart rate, and blood pressure. The superior treatment effect was still evident at 12 months follow-up.

References and brief summation
Carlson, J.G., Chemtob, C.M., Rusnack, K., Hedlund, N.L., & Muraoka, M., Y. (1998). Eye movement desensitization and reprocessing (EMDR) treatment for combat-related posttraumatic stress disorder. Journal of Traumatic Stress, 11(1), 3-24.
EMDR plus routine clinical care was found to be superior to biofeedback assisted relaxation plus routine clinical care for 35 PTSD Vietnam Veterans randomly assigned to each group. Significantly greater improvement was found post treatment and at a 3 month follow-up on a number of cognitive and behavioural instruments such as the Mississippi Combat Scale, the BDI, a self-rating scale of PTSD symptoms, and the Clinician Administered PTSD Scale.

Marcus, S.V., Marquis, P & Sakai, C. (1997). Controlled study of treatment of PTSD using EMDR in an HMO setting. Psychotherapy, 34, 307-315.
Compared EMDR with other psychological interventions tested 67 participants who were referred by a treating clinician as having PTSD symptoms. All subjects were members of a Health Maintenance Organization and were randomly assigned to EMDR or treatment as usual. Treatment as usual was whatever treatment was most preferred by the therapist who received the referral. This included procedures such as psychodynamic psychotherapy, medication, behavioral techniques or hypnosis. They investigated the relative efficacy of each procedure on a number self report and observer rated measures. Significantly greater gains for EMDR after 3 sessions and at post-treatment. The assessment by the independent rater indicated that after three sessions 50% of the EMDR patients and only 20% of the Standard Care patients no longer had a PTSD diagnosis. At post-treatment 77% of EMDR compared to only 50% of Standard Care patients no longer received a PTSD diagnosis. These differences in the diagnostic status were significant.

Rothbaum, B. O. (1997). A Controlled Study of Eye Movement Desensitisation and Reprocessing in the Treatment of Post Traumatic Stress Disordered Sexual Assault Victims. Bullington of the Menninger clinic, 61 (3), 317-334.
She found that sexual assault survivors treated with EMDR improved significantly more on PTSD and depression from pre to post-treatment than those on a wait list. This improvement was demonstrated not only for self report measures but for independent clinician rated observations of PTSD symptoms. Of note is that Rothbaum has previously been involved in trials with Edna Foa comparing behavioural and support strategies for treating PTSD. She noted that from her experience it appears that EMDR is more efficient than other exposure techniques but that comparative outcome studies are needed to investigate whether this is true.

Scheck, M.M., Schaeffer, J.A., & Gillette, C. (1998). Brief psychological intervention with traumatized young women: The efficacy of eye movement desensitization and reprocessing. Journal of Traumatic Stress, 11(1), 25-44.
They investigated the treatment efficacy of an active listening treatment in comparison to EMDR for 60 young women identified as displaying problem behaviors. These women were recruited from agencies such as a drug and alcohol referral center, a court diversion service, and a clinic for the treatment of sexually transmitted diseases. One fifth of this sample had served some time in jail and 60% had partners who had been jailed. Participants were either given two 90-minute sessions of active listening treatment or EMDR. Participants receiving EMDR showed significantly greater improvement on all self-report measures including the BDI, State Trait Inventory, and IES. Superior treatment gains were also evident by blind independent ratings of PTSD using the Post-traumatic Stress Disorder Inventory. Careful attention was paid to treatment fidelity and a therapist involved in each condition had considerable experience with their treatment paradigm. This study is particularly encouraging given some of the pessimism that sometimes exists in treating this population.

Van Etten, M.L., and Taylor,S. (1998). Comparative efficacy of treatments for posttraumatic stress disorder: a meta-analysis. Clinical Psychology and Psychotherapy, 5, 126-144.
They found that in the 41 studies reviewed, EMDR and Behavioral Treatments were significantly superior to all other psychological therapies on observer rated and self report measures at follow-up. However the effect size for EMDR treatments was achieved with fewer sessions. Both these psychological treatments were superior to pharmacotherapy at follow-up.

Wilson, D.L., Silver, S.M., Covi, W.G., & Foster, S. (1996). Eye movement desensitization and reprocessing: Effectiveness and autonomic correlates. Journal of
Behavior Therapy and Experimental Psychiatry, 27, (3), 219-229.
EMDR found to be more effective than an exposure control but that the eye movement component was more effective than a finger tapping alternative. Furthermore the significant advantage of eye movement EMDR was not just on self-report measures but also for physiological measures such as GSR, heart rate, and blood pressure. The superior treatment effect was still evident at 12 months follow-up.


 

Testimonial

Posted by Morc on February 10, 2000, at 23:53:05

In reply to Re: More on EMDR - What is the evidence , posted by Christopher Lee on February 10, 2000, at 5:06:25


I've been doing EMDR psychotherapy for two months now. Guess what folks: It works! Too bad everone here seems so close-minded about it.

 

Morc, how often do you go for EMDR therapy?

Posted by Janice on February 11, 2000, at 18:45:47

In reply to Testimonial, posted by Morc on February 10, 2000, at 23:53:05

> I have an appointment next week to try this therapy for PTSD.

The woman i am going to see is good, but expensive. How many sessions have you had, and are you finished, or is it ongoing?

what type of trauma did you experience? long-term or short-term, and does this affect the length of EMDR therapy?

Glad to hear it helped you.
thank you for your time Morc, Janice

 

Re: Morc, how often do you go for EMDR therapy?

Posted by Morc on February 15, 2000, at 14:35:23

In reply to Morc, how often do you go for EMDR therapy?, posted by Janice on February 11, 2000, at 18:45:47

> > I have an appointment next week to try this therapy for PTSD.
>
> The woman i am going to see is good, but expensive. How many sessions have you had, and are you finished, or is it ongoing?

I'm in the middle of it. Fortunately, I found someone doing it for sliding scale, $50/hr. Right now I'm going 2x/week, intensively.
>
> what type of trauma did you experience? long-term or short-term, and does this affect the length of EMDR therapy?

So far, just the trauma of growing up!, it seems. If there's worse, I haven't yet hit upon it.

>
> Glad to hear it helped you.
> thank you for your time Morc, Janice

I say "it works", because it does clear up focused issues and painful memories. The jury's still out, though, unfortunately, over whether it alone is sufficient to overcome a history of depression and other similar problems. Meanwhile, I'm also continuing on a very small dose of 5HTP, which I increase as needed. Fingers crossed!

 

Re: Morc, how often do you go for EMDR therapy?

Posted by Abie on April 6, 2000, at 17:35:25

In reply to Re: Morc, how often do you go for EMDR therapy?, posted by Morc on February 15, 2000, at 14:35:23

Morc, I've had some EMDR therapy in the past, and am starting a new series next week. Thanks for your encouraging feedback. It's been almost two months since the last posting. I'm guessing you're about through. How are you doing?

 

Re: Morc, how often do you go for EMDR therapy?

Posted by Morc on April 7, 2000, at 22:33:47

In reply to Re: Morc, how often do you go for EMDR therapy?, posted by Abie on April 6, 2000, at 17:35:25


I kind of hate to say this here, but I had to stop it--not because it didn't work, but because it worked too well! It's a powerful instrumentality, and I just couldn't handle it. Evidently I have some underlying biochemical problems that require correction first, so now I'm back to plain old talk therapy, which is also helping a lot. I still believe in it, though, and wouldn't hesitate to use it to address a very focused kind of problem. E.g., I intend to use it to address my fear of flying one of these days!


Go forward in thread:


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.