Eye Movement Desensitization and Reprocessing - Controversy Over Mechanisms and Effectiveness

Controversy Over Mechanisms and Effectiveness

EMDR has generated a great deal of controversy since its inception in 1989. Critics of EMDR argue that the eye movements do not play a central role, that the mechanisms of eye movements are speculative, and that the theory leading to the practice is not falsifiable and therefore not amenable to scientific inquiry.

The working mechanisms that underlie the effectiveness of EMDR, and whether the eye movement component in EMDR contributes to its clinical effectiveness are still points of uncertainty and contentious debate.

Although one meta-analysis concluded that EMDR is not as effective, or as long lasting, as traditional exposure therapy, several other researchers using meta-analysis have found EMDR to be at least equivalent in effect size to specific exposure therapies.

Despite the treatment procedures being quite different between EMDR and traditional exposure therapy, some authors continue to argue that the main effective component in EMDR is exposure.

An early critical review and meta-analysis that looked at the contribution of eye movement to treatment effectiveness in EMDR concluded that eye movement is not necessary to the treatment effect. Salkovskis (2002) reported that the eye movement is irrelevant and that the effectiveness of the procedure is solely due to its having properties similar to cognitive behavioral therapies, such as desensitization and exposure.

A 2009 review of EDMR suggests further research with different populations is needed.