Science & Pseudoscience Review in Mental Health

The null hypothesis, which assumes that no difference exists until a statistically significant effect is demonstrated, is the keystone of scientific testing. Nevertheless, the field of psychology recently has seen the null hypothesis turned upside down in the promotion of Eye Movement Desensitization and Reprocessing (EMDR), a popular new psychotherapeutic procedure now proposed as a treatment for a wide range of problems including Post-Traumatic Stress Disorder, self-esteem issues, and achieving "peak performance."

Television documentaries have attested to the power of EMDR, presentations on the procedure are being given at some of the most prestigious psychiatric centers in the nation, and EMDR's "discoverer," Francine Shapiro [a], was given the 1994 Scientific Achievement Award by the California State Psychological Association.

Shapiro says that while walking in the woods she discovered that anxious thoughts left her consciousness as she experienced spontaneous saccadic [b] eye movements. [c] From this she developed the technique of waving fingers in front of patients' eyes to produce "sets of saccades" while the patient imagines traumatic scenes and lets his thoughts and feelings go where they might.

Shapiro tried this new technique on 22 individuals who had reactions to old traumatic memories and reported [1] that all patients experienced profound reductions in their subjective distress to the disturbing scenes and memories in just one session--extraordinary clinical performance for a therapeutic procedure. As a result, interest in EMDR among mental health professionals has been phenomenal. Shapiro's report was published in 1989, and by 1992 it was estimated that 1,200 professionals had been trained in the method. It is now (early 1996) believed that over 20,000 professionals have been trained at workshops that cost over $350 to attend.

Meanwhile, several researchers have gone through the laborious effort of randomly assigning patients to EMDR or standard imagery treatment without eye movements. In almost every case, eye movements have provided no additional treatment effect. [2,3] When initial studies failed to support EMDR, Shapiro claimed that researchers had not received proper training in the techniques, so their work did not provide a fair test. After researchers took the appropriate workshop, the need for them to have Level II training was introduced despite the fact that no research had been done to justify such a requirement. When studies clearly showed that eye movements were unnecessary, Shapiro shifted the rationale of treatment and offered alternative forms of stimulation such as finger snapping and tapping motions.

What appears to have happened is that Shapiro took existing elements from cognitive-behavior therapies, added the unnecessary ingredient of finger waving, and then took the new technique on the road before science could catch up. Whenever findings failed to support EMDR's claims, a bold new pronouncement was made and the null hypothesis was again turned upside down.

The acceptance and proliferation of EMDR by psychologists represents a fundamental shift on their part of basic assumptions about the burden of scientific proof. Before it was demonstrated that eye movements are essential, thousands of professionals started waving their fingers, and it appears they may continue to do so until convinced otherwise.

We believe that claims for EMDR should be advanced only after acceptable levels of proof have been achieved. Also, because extraordinary results are claimed, we believe the dictum that "extraordinary claims demand extraordinary proof" should be applied.

Notes

a - Shapiro's doctorate is from an unaccredited Professional School for Psychological Studies, San Diego, a now defunct "authorized" school. "Authorized" is the lowest level assigned to proprietary schools in California, followed by "approved" and "accredited."

b - Rapid, involuntary small movements of both eyes simultaneously (Dorland's Medical Dictionary).

c - Rosen questions Shapiro's original story, noting that people typically are not conscious of their own spontaneous, involuntary eye-movements.4

References

1. Shapiro F. Efficacy of the Eye Movement Desensitization procedure in the treatment of traumatic memories," J Traumatic Stress 1989;2:199-223.

2. Lohr et al. The empirical status of the clinical application of eye movement desensitization and reprocessing. J Behavior Therapy & Experimental Psychiatry 1995;26:285-302.

3. Pitman et al. Emotional processing during EMDR therapy of Vietnam veterans with post-traumatic stress disorder, Comprehensive Psychiatry, 1996;37:419-29.

4. Rosen GM. On the origin of eye movement desensitization. J Behavior Therapy & Experimental Psychiatry, 1995;26:121-2.

About the Authors

Gerald M. Rosen is a clinical psychologist in private practice in Seattle, Washington, and holds a joint appointment as Clinical Associate Professor in the Departments of Psychology and Psychiatry, University of Washington.

Jeffrey Lohr is a Professor of Clinical Psychology, Dept of Psychology, University of Arkansas.

*This article appeared in the January-February 1997 issue of the NCAHF Newsletter and is copyrighted by NCAHF. Permission to reprint this article was granted if suitable attribution is made to the NCAHF.

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