Can EMDR Be Harmful?

Overview

I occasionally get asked if I am trained in EMDR, a treatment that has become more popular in recent years. While I am very familiar with it, I have chosen not to get trained in it because I do not feel there is enough scientific evidence supporting its efficacy. Unfortunately, this can mean that potential clients are sometimes disappointed. How can so many swear by EMDR if it is not particularly effective? Well, for a few reasons.

What The Research Says

It does seem that EMDR is more effective than doing absolutely nothing. However, this may mean that individuals who have received EMDR after never having received any therapy are mainly improving due to contact with a clinician as opposed to anything associated with EMDR in particular. They may have felt better after a few months of therapy that did not involve EMDR. 

Furthermore, one meta-analysis concluded that the eye movements associated with EMDR are probably unnecessary and that improvements seen with EMDR are likely due to the exposure that it provides to distress that has been avoided, something that is a key feature of Prolonged Exposure, an intervention that has long been used with veterans and is considered to be a gold standard treatment.

Additionally, it does not appear that there is any research that would indicate that EMDR produces better results than such gold standard cognitive therapies for PTSD, which also include Cognitive Processing Therapy.

Further complicating things, it appears that research done on EMDR is highly prone to bias. It is, after all, impossible to conduct a double-blind study of EMDR. 

What This Means

What does all the hype about EMDR mean? Most likely, it just points to the fact that therapists are human like everyone else. EMDR, with its trendy appeal, may be a passing fad. Knowing that there is demand for it, many therapists will seek out training in it. Without clear scientific evidence that would demonstrate that it is doing anything new or different, however, I believe that the best choices that we have for treating PTSD are still Prolonged Exposure and Cognitive Processing Therapy.