EMDR Controversy: Is It Effective?

EMDR does this through bilateral stimulation, which can include guided eye movements, holding tappers, and even audio sounds, to stimulate memories, thoughts, and feelings that are holding negative beliefs and distress. Because EMDR has recently become trendy, controversy and skepticism surrounding it are no surprise. Rather than letting this deter you from EMDR, we hope it prompts you to discover what you think for yourself. This article will not only address the concerns with EMDR, but it will also share balanced insights into the therapy and invite you to critically consider its usefulness in the right settings with the right training.

Why Is EMDR So Controversial?

EMDR originated with Francine Shapiro in 1987, who noticed that rapid eye movements helped decrease the emotional intensity of distressing thoughts. Let’s take a look at some of the reasons there have been doubts surrounding it since:

 - Some scientists thought it was another pseudoscience. Initially, people thought it wasn’t backed with enough evidence and felt too “mystical” or simplistic for complex trauma. Although some people still think this, it’s been proven to be evidence-based since then.
 - Results are seen faster than traditional talk therapy. Compared to traditional talk therapy, EMDR is less about verbal processing and analysis and more about processing through sensory and emotional pathways. There has been resistance to EMDR because of mixed research findings with which is more beneficial.
 - Uncertainty with why it works. Some researchers believe that the bilateral stimulation is the key to EMDR’s effectiveness while others argue it’s the exposure to traumatic memories in order to replace negative cognition with a positive one. Some feel this confusion makes EMDR less credible.

Though these concerns are completely valid, they are exactly what makes EMDR therapy worth investigating. Although it may be unconventional, there’s a reason for its rising demand and significant benefits in clients.

 Is EMDR Evidence-Based?

A therapy is considered evidence-based when the treatment is backed by scientific research proving its efficacy for specific mental health conditions. This means they have undergone intense testing through controlled studies and by following proven methods. Here are some details surrounding the evidence for EMDR:

 - Multiple high-quality studies with randomized control trials (RCTs) have shown EMDR to be effective at reducing symptoms of trauma, anxiety, and emotional distress. 
 - Standardized techniques are used to practice EMDR therapy in a structured, reliable way that trained professionals consistently use across the board. 
 - The treatment has been tested to treat specific conditions such as PTSD, depression, anxiety, and OCD with as much efficacy, and sometimes greater speed of results, as Cognitive Behavioral Therapy (CBT). 
 - Research studies are continually being published so that EMDR therapists can remain updated based on the latest findings.

EMDR therapy is also recognized by both the American Psychological Association (APA) and the World Health Association (WHO), both of which recommend it for trauma-focused intervention. Below are the reasons EMDR fits their guidelines for treatment:

 - The treatment is trauma-focused, targeting the distressing memories directly.
 - It’s evidence-based, specifically proven through randomized control trials and other large-scale meta-analyses.
 - It doesn’t rely heavily on verbal processing which can be beneficial for many trauma clients.
 - It promotes adaptive information processing and long-term results and relief.

Lastly, multiple studies have brought evidence to light that the eye movements or other bilateral stimulation help reduce emotional intensity and enhance memory reprocessing. Specifically with the eye movements, this allows for a reduced vividness of the memory, lessened emotional charge, and increased cognitive flexibility in both hemispheres of the brain. Both the APA and WHO endorse EMDR because of the outcomes and acknowledge that any practice will continually evolve through further studies.

Evidence Supporting Effectiveness

You may be wondering what some of those major EMDR research findings are? Two significant cases to know about are those by Watts et al. in 2013 and Chen et al. in 2014. The Watts et al. case was published in Psychological Medicine and reviewed 33 randomized controlled trials focusing on EMDR and trauma-focused CBT. It found that EMDR was just as effective as trauma-focused CBT in reducing PTSD symptoms with lower dropout rates. The Chen et al. case was published in Behavior Research and Therapy and evaluated 24 studies involving both adult and child audiences with trauma histories. They also found a significant reduction of trauma-related symptoms in fewer sessions with positive effects maintained over time. 

EMDR began to officially be recognized as an evidence-based treatment for PTSD in the late 1990s and early 2000s. The U.S. Department of Veterans Affairs (VA) & Department of Defense (DoD) first included EMDR in their treatment guidelines for PTSD in 1999. The APA’s Division 12 (Society of Clinical Psychology) added EMDR to its list of empirically supported treatments shortly after in 2000. Other important real-world applications of EMDR include the following:

 - Other military personnel and veterans with PTSD.
 - Sexual assault and domestic violence cases or in domestic violence shelters.
 - With disaster response teams in post-conflict zones or refugee camps.
 - With children and teens struggling with trauma, depression, anxiety, bullying, etc.
 - With other serious medical diagnoses and any related trauma.

In clinical trials, 77–90% of single-trauma clients no longer met criteria for PTSD after 3–6 EMDR sessions. Unlike some talk therapies, EMDR often requires fewer sessions, and clients are not required to provide detailed trauma narratives, making it a good option for those with complex trauma or verbal processing challenges.

Risks of EMDR Therapy

Despite the effectiveness of EMDR, there are risks as with any therapy practice. With EMDR specifically, you should be cautious with the following things:

 - Potential for temporary distress or overwhelming emotions as the reprocessing of the memory occurs.
 - The client's possibility to dissociate or experience related symptoms.
 - Possible retraumatization if not done with proper preparation, training, and patience in each phase.
 - Unfinished processing between sessions that leave lingering discomfort.

In addition to the risks mentioned above, it’s important to be aware of any EMDR side effects as well. Those can include vivid dreams, extended emotional vulnerability, fatigue, and other discomfort. Nonetheless, proper implementation of EMDR minimizes the risks and side effects.

Benefits of EMDR

With these risks in mind, it’s important to note the benefits as well. In summary, the benefits supported by the evidence in most cases and by reputable health organizations world-wide are as follows:

 - Faster progress and relief of symptoms compared to traditional talk therapy.
 - Specific success with PTSD, anxiety, and other trauma-related conditions.
 - Evidence for long-term, sustained impact and healing.
 - A holistic healing approach that involves reprocessing the past experiences.
 - A growing acceptance, usage, and endorsement of the therapy from both therapists and clients.

Should You Consider EMDR Certification as a Therapist?

Skepticism surrounding EMDR still exists, and probably always will, because questioning and testing methods in the psychological world are a healthy part of professional growth. We’re here to help you explore what EMDR is so you can feel confident in its role in therapy.

It’s important to recognize that EMDR is evidence-based, effective, and trustworthy, but just like with any other therapy, no one therapy should be viewed as a cure-all or a gold standard for trauma. EMDR may not be for everyone. Every individual client should be approached with intentional and thoughtful care, and being trained in EMDR expands your toolbox so that you can offer it to clients on a case by case basis. 

If you’re interested in learning more, we’d love to equip you with more resources, an opportunity to start basic training, or to experience an intensive for yourself.