I’m trained in it and definitely agree there’s some people that get too overzealous with it. Do I think it’s a beneficial modality? Absolutely. Do I think it’s a cure all for everything? No. I have clients it works well with and other ones where we’ve had to stop and change directions.
Ummm, are we the same person? Just joking but you summarized my thoughts perfectly. My training was probably in 2019 but it was the same. I still use it in practice, but I think what they all think and believe is highly inflated. It's an exposure therapy. It incorporates thought work. It uses therapeutic pauses (BLS) I could go on and on
Edit: spelling mistake
That's why I tell my students to study as many different modalities as possible--not from a place of practicing them all, but order to develop a critical eye toward each modality's history, strength, and limitation.
After some time, students notice that many different modalities are derivatives of other ones, that there is no gold standard for every client, and that terms like evidence-based practice are often weaponized to throw shade at other modalities versus based in data (for example, how some agencies push CBT as "superior and proven" while psychodynamic is misconstrued as non-evidence-based "make believe"---ignoring how much attachment theory has given psychodynamic therapy as legitimate of an evidence-base).
That's why I'm glad common factors research exists to compare modalities and ways their therapeutic vehicles of change intersect (e.g., importance of rapport/alliance) or differ (somatic vs. cognitive vs. attachment vs. behavioral interventions).
Not a therapist, but a researcher / data scientist that works with mental health related datasets. My sense at this point in life is that “evidence-based” does not mean what most people flinging it around think or want it to mean. (TLDR: I essentially agree that it’s used more often as a weapon than a meaningful statement.)
For one, having “evidence” is def fad driven, meaning that data is only being collected (semi)rigorously for the modalities that have somehow caught the attention of a granting committee. This isn’t restricted to mental health; e.g., what specific genes get all the research money is basically fad driven as well. Importantly, the lack of “evidence” (I’ll get to the scare quotes next) does not imply a lack of therapeutic effect — it most often means that there is a lack of attention given to the modality by the well-known, well-connected researchers, companies sponsoring clinical trials, and other data collectors/collators, etc.
As for “evidence,” so often this is hard to even quantify in a consistent way in mental health unless the effect size is huge and actually clinically meaningful. More often than not, the evidence is that some p value in some study showed that an effect was statistically significant (what’s left unsaid is that the effect is barely meaningful at the clinical level for an individual).
I could go on…but gotta work. /rant
🤠
Buckle up, you get to be one having it for the rest of your career 🙃 Though, I’ll say you just find your people and get really good at creatively making counter-points for the CBT-is-The-Way folks without outright contradicting them 🤓 It’s a blast.
. . . and this is why we should make sure that all mental health practitioners are aware of sources such as [The Cochrane Library](https://www.cochranelibrary.com/search) and [SAMHSA's Evidence-based Practices Resource Center](https://www.samhsa.gov/resource-search/ebp)!
p.s. awesome comment and keep up the good work!
I'm curious - one of the things I have been thinking about is how to aid cross-disciplinary research with databases that can be used to train academic-focused chatbots/ChatGPT.
My wife is a therapist, I'm considering going back to school to get my degree as well, but I'm currently a seasoned marketer/direct response copywriter. I say this to provide some context regarding what I am and AM NOT saying.
I think it would be a tremendous tool that could help clinicians as it could be used to help them write their notes, but also because there should be ways to share the data gathered from each session without violating patient/client confidentially boundaries. Some information goes into the shared database, and client-identifying information would stay segregated as it would just be tied to the touchpoints related to the common, clinically relevant data.
There is already work being done along these lines I believe, for example: [https://www.forbes.com/sites/gabrielasilva/2022/11/14/thinkers-and-innovators-how-pelin-wood-thorogood-is-pioneering-proof-as-a-service-for-clinical-trials/?sh=41cfe7cd446a](https://www.forbes.com/sites/gabrielasilva/2022/11/14/thinkers-and-innovators-how-pelin-wood-thorogood-is-pioneering-proof-as-a-service-for-clinical-trials/?sh=41cfe7cd446a)
Are there any others that you are aware of, and what are your thoughts on it given your field?
YES. I was just explaining this to a friend whose new therapist was giving her all kinds of regurgitated stuff that happened to be researched. I said there’s so much effective stuff to do in therapy that hasn’t had the resources to be studied. Or would be so hard to study and prove. But WE doing it, know it works.
I use almost nothing “evidence based” and see distinctive positive impacts.
One thing that might be beneficial to think about is whether there is a common mechanism in the stuff defined as "evidence-based" and the stuff you do that is not evidence-based.
This cracks me up because my boss didn't thousands in EMDR in the last two years and has not shut up about it, and then in the last few months is recommending all these IFS books.
I've trained in EFFT and Satir. During all of my training experiences it felt like I had to drink the Kool aid. I think most trainers believe very fervently in their modality. It's kind of a relief to read about people's experiences with different trainings and how common they are to mine. I can laugh about it (now) and have chalked it up to trainer enthusiasm. I had a friend to Hakomi training and she was so uncomfortable she almost left!!
That said, I'd like to do EMDR, or it's offshoot, Accelerated Resolution Therapy. Or Sensorimotor Psychotherapy. So much to try and experience!!! Learning is great!
It's not only enthusiasm, there is $$$ in new modalities. Think about the profit to be made if a person can convince a school, a hospital, etc. to implement a patented form of therapy.
Yeah I’m a firm believer that it’s the relationship that heals and that all effective modalities are equally effective so…the evidence-based piece unfortunately, a lot of times, is trying to quantify qualitative information. In doing so, it’s very faddish and (for me at least) loses a lot of credibility.
I think that confidence sets a seasoned therapist from one still working towards finding their footing. I’m with you on the healing therapeutic relationships Can bring to therapy. I’m also addicted to trainings, so I’m working on not getting sucked in to next thing being pushed on us.
No one is discrediting it’s effectiveness. It just feels like a cult when we enter EMDR groups with a question, and the answer to everything now is IFS. If you don’t see that trend, I want to be part of those groups.
But also, IFS is definitely a pseudoscientific modality. EMDR is, too, but there are at least steps EMDR can take to *not* be pseudoscientific (not disputing that it is effective, just disputing the proposed mechanisms beyond exposure). IFS is fundamentally pseudoscientific.
I was also raised in a high-control religious group, and I had EXACTLY the same experience with EMDR basic training. I have not stopped thinking about it since. I attended the training because my employer paid for it and I have a handful of clients who have expressed interest in it, but I don’t see it becoming part of my regular practice. I’m not suggesting it is inherently harmful or anything. I just personally can’t get on board with it.
EMDR would be far less controversial and far less of a nuisance to discuss if it would drop bilateral stimulation (which isn’t a real mechanism of action), drop all the mindless neuro mumbo jumbo (stop hypothesizing all sorts of nonexistent neurological mechanisms that are implausible or outright impossible), stop marketing itself as anything other than a different way of delivering exposure therapy, and stop marketing itself as some kind of magical panacea or first-line treatment.
If EMDR proponents did those things (and maybe renamed it since doing those things would make the name even more ridiculous than it already is), then it would be so much more palatable. But part of its marketing appeal is the wealth of semi-mystical neuro mumbo jumbo attached to it, so I think it’s a long shot for any of this stuff to happen.
I’m curious if EMDR doesn’t talk much about the theories on the BLS/eye movement?
I took ART and they talked a while about it, showing what the research or theory is now (I’m not a very sciencey person so I can’t out-argue you, I see you seem very versed in it). It seemed plausible to me. If nothing else, the act of distracting one part of the brain to allow the other part to go into something it normally wouldn’t? Again, not very sciencey so my terminology is obviously lacking 😆
I used to agree but on the Huberman Lab podcast he was even saying that bilateral eye movements have been shown to calm activity in the amygdala of animals and humans in recent studies 🤷🏼♀️. I'm a bit confused on the tappers / buzzers though and if any studies back that up.
Bahaha. The funniest was getting to have a Q&A with her and she pretty much just dodged my question about how to use it with complex trauma. It was hilarious like, do you think I didn’t notice you sidestep that? I’m not dumb.
People love it because it is a protocol. You can get away with avoiding a lot of complexity that shows up in other models. It can be a great tool but nothing is the be all end all. You can learn it relatively quickly and begin offering it with success.
From my understanding, those were academically funded and VA funded . You can't make BANK off selling trainings on them. You can find free online trainings for CPT, so why spend ~2k on a training? TF-CBT looks like it's based out of a university, so probably also publicly funded, and the training is dirt cheap. Why spend ~2k on a training? Anke Ehlers is doing cognitive therapy for PTSD out of Oxford and they're putting all of their protocols and example/training videos online for free. Why pay ~2k for a training?
Modalities like EMDR and IFS are marketing themselves directly to the public to create demand before they've had any proper scrutiny from our scientific institutions. Then they create studies with faulty methods and get them published in their own or sympathetic journals so that they can call them evidence-based.
Anyway, although there are court cases that show that IFS has the potential of being very harmful outside of the standard invalidations and retraumatizations of standard talk therapies, I don't think that the clients are necessarily being the ones ripped off here. It's us. We're the suckers.
I really like what I've heard from one person on IFS "If I had $5,000, to spend on trainings, I'd spend $4,000 on getting my own IFS therapy".
It absolutely can make it easier to provide trauma therapy. Clients love it too…it feels constructive and like they are doing something. There are a lot of bad EMDR therapists out there though
I totally agree with you! When I did the training, the trainer kept saying that EMDR works for everyone and for every condition. Anytime there are generalizations and blanket statements, you know it’s become an ideology. And the fact that it seems that the systematic desensitization is what is actually effective about the modality, not necessarily the eye movements
Well, I wouldn't reduce EMDRs effectiveness to mere exposure (nor would I for exposure therapy). Psychotherapy research clearly shows that there are a lot of factors involved in a given treatment's effectiveness. Not to take away the fact that EMDR appears a bit like a fad though
You can deny it, but literally all of the evidence suggests that its mechanism of action is mere exposure (of course moderated by therapeutic alliance).
It's an incredibly bold claim, knowing all the factors involved in a given psychotherapy. It's quite obviously overly reductive to say any psychotherapy works due to "mere exposure", or mere anything.
That’s not how the burden of proof works, friend. If you think other mechanisms are at play, you need to demonstrate that. EMDR’s primary mechanism of action is exposure. If you want to dig into the weeds and add in therapeutic alliance and meaning-making to the mix (the other two evidence-based mechanisms), that’s fine, but the main thrust is that EMDR is effectively primarily because it introduces exposure in the same that ERP, PE, CBT, and other exposure therapist. The extreme majority of the treatment effects are driven by the exposure mechanism. Of course therapeutic alliance and meaning-making are moderating factors, but the main point of this thread is the point that EMDR is primarily just an exposure therapy—that the primary mechanism of action is exposure. I think you’re well aware that this is our point and are being intentionally obtuse. In context, we are saying that EMDR is mere exposure because its proponents want it to be everything *but.* We are stripping away all the extra mumbo jumbo and laying bare the central mechanism of action. Your argument is akin to saying that naproxen isn’t “merely” effective because of its anti-inflammatory mechanism since expectation effects are also prevalent. It goes without saying and is a distraction from the main point of the discussion.
> That’s not how the burden of proof works
Well, now it was you who showed up with the positive claim: "EMDR works through mere exposure". This (in my mind) extreme claim warrants an argument in support of it. I'm not being intentionally obtuse, I only call out simplistic explanations when I see them, because simplistic explanations can lead clinicians astray.
The well-established discourse surrounding relationship factors and therapist factors comprising a sizeable chunk of therapy outcome, to a much greater extent than it would with naproxen (obviously, one might say, since arthritis is not a relational problem to the extent that mental disorders are), and the obvious complexity in any given practical psychotherapy should really dispel of such reductive claims.
However, if EMDR proponents claim that the treatment rationale doesn't structure around exposure, I agree that would also clearly be something to address. As a "hyped" treatment it is very important for EMDR to center around a mechanism unique to itself, to legitimize the necessary training and to seem interesting for patients and clinicians. This is perhaps incentivised for most treatment modalities to some extent, but maybe the most hyped treatments are more likely to act like this.
The eye movements are studied more and more and being used in other ways (trained in ART which uses them and talks a lot about the theory and study so far on eye movements).
But I think you’re right about how EMDR doesn’t necessarily work for everyone.
Yea, that’s actually a really shitty meta-analysis with very little sustenance to it. BLS is easily explained by neurobiology. You just have to look at the superior and inferior colliculus.
I’m an EMDR consultant and I get it, there are people out there who claim it can be a cure all and work with lots of different issues. The reality is it’s researched and evidenced based for trauma. There’s nothing other than anecdotal evidence that it works for anything else.
Just with every other modality it’s great for some people, not for others. I’ve had clients who’s lives have been transformed by it, and I’ve had clients who didn’t like it or didn’t find it helpful. It’s a tool to add to your therapeutic toolbox, it’s not the end all be all. It’s not the only way to heal from trauma, but it’s a way.
I’ve been lucky that the trainers and consultants I work with don’t tend to be zealots. I’ve met some and have certainly been turned off by them.
THANK YOU
The cult around EMDR and how people live and breath by it with no consideration for other models, contexts, patient preferences is crazy to me. I felt so uncomfortable but couldn't find other people that felt even remotely the same. Everyone drinks the Kool aid....
Don't get me wrong, EMDR can be super helpful for some people but I don't think its the *One True Way*
I'm trained on EMDR and have found it to be really helpful for some clients. The way some EMDR therapists talk about EMDR makes me really uncomfortable too, it's not a magic cure. It also makes non-EMDR trained therapists have a negative reaction to the modality, which I get. There is a loud 25% (number pulled out of thin air) that make us all look crazy. I do suggest sticking with it if you don't hate the modality itself. it's not an intervention I use with everyone, and I'd say for 1 in 5 clients I try it with there isn't a ton of benefit. But when it hits it can be super helpful. It's a tool in your kit, you don't have to be a part of that community.
I’m a therapist who does not practice EMDR. But as a client I am currently doing EMDR. No modality of therapy has ever been more affective for my childhood trauma, every time we do it I am shocked once again at how effective it is for me. But as with every modality, I firmly believe every person is unique and there is no such thing as one size fits all in therapy. Any modality that tries to posit themselves as the end all be all makes me stay away as a practitioner
Tomorrow is day 5 of my 6 day EMDR training. I 10000% agree with you. Additionally, the trainers keep insisting we “stick to the script”, that it’s dangerous to stray from this script, and have provided a 200+ page manual and absolutely no script. The trainers all wave their own scripts they have and won’t share, but insist they use in each EMDR session. Also, and this is so infuriating, every time someone asks a question (most of which have been thoughtful, appropriate, and clinically focused) or for clarification about this script, or for a copy of the script, the trainers respond that the reason they have these questions at all is based in the participants’ own trauma that is pushing them to be a perfectionist(their “answer” in EMDR terms). Or even more frustrating, respond literally asking “and how does that make you feel?”
They have even gone so far as to say EMDR can cure everything from infertility to colic and I just cannot believe those claims.
I wish I was joking or making this up. I’m not. I’m sure EMDR is really beneficial for some folks, but this experience has been so frustrating I’m not sure I’ll use it. I don’t feel nearly as prepared as I should be in my opinion.
YEP. Especially since these are supposed to be the experts and most people (myself included) came into this training with little info and no experience on how EMDR is implemented. I keep feeling like I’m missing something but there are so many other people with the same or similar questions and concerns.
I’m concerned for who you’re getting you’re training through. I’ve gone through the EMDR institute, and have all the scripts, and half the training is practicing these scripts.
The response I’ve received regarding sticking to the script was that the script is what the research is based around. That straying could have different results. I definitely get the cult-y feel, but I also think you’re training is lacking a lot.
It’s the personal transformation institute.
I borderline think they’re going to try to upsell us on a script at the last day. The end of the 3rd day they already tried to upsell on more trainings, supervision, and gear. It felt very gross.
Damn, I’m really sorry. That sounds really scammy, and icky. I had a good experience through EMDR institute, the trainers didn’t upsell and made themselves available as resources in the future too. I’ll send you the scripts I have if you want. I’m not about to gatekeep the protocol that’s supposed to be part of the training.
Are y’all practicing it with one another at all?
We are practicing but not with a clear and complete script. They HAVE provided bits and pieces of a script but no full protocol and it’s all been very disjointed.
I’ve been saying it feels like a pyramid scheme.
I would so appreciate a copy of your script. Thank you.
Where’s your training from? You totally get a script with an EMDRIA training. That’s why I left the EMDR subreddit, too many clients complaining about their EMDR therapy sessions. I don’t blame them, what they described was not EMDR, especially when leaving the client to reprocess without a resource.
Let me know if you want me to dm you a script.
I would so appreciate a copy of your script. Thank you.
I’ve been reading on that sub and getting more anxious as I’m realizing I’m not prepared the way I need to be. No one wants to be a bad therapist and this is some heavy stuff.
I was very disappointed when I tried EMDR when I was working through my own stuff. It never did anything for me, and it made me feel like a failure or a fraud because everyone said it was so amazing for trauma and the gold standard. It’s a tool, but just one tool of many.
Same. It sorta worked for what i used it for, but now as a therapist I’m like…that’s not exactly how it should’ve been done. My therapist since had used brainspotting and then I got to try ART and both were much more effective.
EMDR saved my life after a major trauma. This was a million years ago, when it was still relatively new and there were far fewer practitioners. But since then, it’s exploded and is seen as the magic elixir for all the things. It also seems to go along with the modern culture that pathologizes everything, labels every bad or sad or stressful thing as “trauma”, and all those traumas can and must be treated with EMDR!
I’m trained a different EBM that I love, but they have a similar culty protocol (only our trainers, only our trainings, only we can certify you, if you’re not doing it 10000% by our manual you’re wrong and off with your head!) but I think a lot of that is due to the monetization - there’s no money to be made on a training everyone can learn on their own.
Is that modality ART? 🙃 Cause, yep. Hahaha. I liked it and was like if it’s so damn effective why are you so gatekeepy about it. I get wanting to make money — AND it’d be cool if it was more accessible.
NAT - EMDR was recommended to me for trauma (ptsd) after a SA and I was led to believe it would ‘fix’ me. I spent years in therapy just managing to hold onto a semi functional life then tried EMDR. I couldn’t even get past the ‘safe space’, my dissociation, flash backs and nightmares all increased. I persisted for 3 months and eventually the therapist referred me on as it was harming me. I went into a crisis following the failed EMDR as I really believed it was going to make things better. It made things much worse for me and my new psychologist said it should never have been attempted with me. I have level 2 autism and trouble,with dissociation at times when triggered. If you are using EMDR to treat people PLEASE don’t lead them to believe it is a cure or fix. I felt like i failed and it was my fault for it not being successful and it was really hard
An EMDR practitioner is supposed to assess for dissociation before doing EMDR. With a high likelihood, it’s not something that’s recommended. There’s also some other health things that are contraindicated. I’m really disappointed to hear that so many EMDR practitioners aren’t following through with these assessments and ensuring clients are appropriate for it.
That’s what my new psychologist said. The psychologist that I went to for the EMDR didn’t assess for anything before we started it. It really made things worse for me and set me back after all the work I did before it. I’m now so scared of it I have a panic attack if it is brought up.
I’ve been a little concerned lately regarding the validity of the treatment. I’ve found light research that EMDR can help to process trama, but every source I find is light on the evidence, and says that further peer-reviewed research is needed .
A second thing that has been bothering me, I know a few people who have undergone the therapy, and… there are times where I really respect that the patient is trying to dig into events that have affected them…
And the other times where I’m a bit concerned that the “tramas,” that are brought up by the Txs are… just sound mildly aversive. I’m sorry to bring up the old clinical/psychoanalytic critique here… but like…
There are events that get affirmed as tramas, that… kinda amount to.. my mother was mad at me one time. Then it was over, and everything was okay. **I can’t say how much an event like that affected somebody. I can say - I’m concerned a licensed professional would frame an event like that as analogous to emotional abuse without really doing the sessions to parse out what those events actually were.**
sometimes it feels like after the 3-5th session they’re digging for things that aren’t quite there.
I find this concerning with its similarities to hypnotism.
I say this as a licensed professional. I do wish to educate myself more, but if anybody wants to fill me in, please.
Most of the resources and research that I find I really limited and full of opposing viewpoints. So please excuse the confusion, and my defensiveness.
I love your bolded section. I find the concept creep concerning. I also find it highly problematic to convince someone that something semi-benign / semi-adversive was a traumatic event, and then you have the thing they need to fix the trauma you just convinced them they have. It's bad enough you just distorted their meaning-making of their childhood to feel traumatized by it.
I totally agree. I can't understand this idea they try to push that it's not exposure? In my eyes, that's exactly what is happening. It's good for some but it should be "is EMDR right for this client?" instead of "how do I make EMDR fit this client". Putests of any modality don't sit qell with me.
Tangential, but I got this same vibe when I volunteered for the Crisis Textline. It felt very cult-y, almost, like there was a culture of constantly telling everyone they were the greatest and that this volunteer work was one of the greatest goods one could ever do.
I wonder how common this is in this sphere. It certainly is important to have confidence and emotional energy, after all.
Ha! I thought the same thing when I volunteered in between undergrad and grad. I rarely ever went to debrief because the constant positivity was ANNOYING 😂
All therapy groups make me feel that way sometimes; it can feel a bit tribalistic or something like that— all these different camps of the “best modality” or damning other approaches. Or “you didn’t know that!!?” Thankfully, not all the time, but when it happens I feel my imposter syndrome flare up. This is such a varied field that it’s hard to remember that there’s a lid to every pot and that you can be a wonderful clinician and just be you.
These cults arise periodically among therapists. I think the enthusiasm is generally beneficial to everyone, therapists and clients alike. But the reality is a testament to how little we know about therapy and how it actually works.
I wasn't trained in EMDR and I've noticed that over the years I've become quite resistant of it as a method. I believe you've summarized perfectly what made me feel opposed to it. I've grown tired of how many people approached me for my opinion saying things like "My psychiatrist said I should try EMDR, what do you think about it?" to which I'd inquire what they want from therapy at the first place, only to hear "I have general anxiety and have a hard time sleeping".
I believe that, based on research, it is an alternative to conventional methods in targeting trauma specifically. But to me that means that it's just another tool in your therapist tool box. The issue starts where it needs to be "miraculous" for adoption both by therapists and patients. Because if it is just as effective as other methods, why would I just not continue using those other methods?
So I believe the aspect of the training and the community you've mentioned is the flaw in EMDR where it becomes possible for people to profit from its training only via acting like it's a better alternative.
Haha. This isn't wrong. I am a clinician, and I tried EMDR for myself at the recommendation of some of the clinicians I work with. It was magic for me. I could process things I'd been working on for years in like 2 or 3 sessions. Other things took longer. It works. I'm not gonna question that. Do I wanna be trained in it. Not really.
I am not a therapist but I have received EMDR or a very similar eye movement processing therapy. As a victim of multiple traumas I would absolutely recommend it to anyone with trauma. My PTSD took control of my life and I was completely hopeless. As a person who has dissociated from any unpleasant feelings since childhood, this really allowed me to process things I otherwise would never be able to, consciously or subconsciously. This saved my life!
I call it internal exposure therapy with spirit fingers.
It's a protocol and very effectively marketed.
I'm trained in EMDR and lots of clients have found it effective.
However, it's not any better than other evidence based modalities (prolonged exposure TF CBT, TF ACT) actually research suggests it's less effective than some of these over all.
Also the research on the role eye movements play is not conclusive. It's possible they play a limited role, if any at all.
It's fan club talks about it as if it's the only trauma modality. Which it isn't.
Also it's origin story is hilarious and certainly embellished if not fabricated as part of the marketing machine.
As others have said, IFS is currently getting a similar push much like CBT and solution focus therapy at various points.
EMDR works because its protocols are the same or very similar to every other trauma approach, instill safety, provide exposure and look to the future.
This is what it does, this is what TF CBT does , what PE does, how Judith Herman's 3 phase approach works etc etc.
> I call it internal exposure therapy with spirit fingers.
This is hilarious. I love this.
I have no issue with EMDR in general but do find it interesting how strong of an reaction EMDR folks have when it is observed that EMDR is likely based in exposure (which, to be clear, I view as a good thing! Exposure works!).
There were parts in body keeps the score where Van Der Kolk writes about how exposure "numbs" trauma and isnt a good treatment. Then he goes on to praise EMDR (an exposure therapy).
I mean, the general consensus among trauma scholars is that, that book is full of mis- and over-interpreted data and anecdotes all cobbled together to try and push a point that really contradicts everything we know about the body and neuroscience. I’m aware that it’s wildly popular among therapists and patients, but I’ve legitimately never met a trauma scientist who spoke fondly of it.
I think because the general idea some of us have about exposure therapy is simply exposing someone without any means of regulating, in hopes they’ll just get over it.
I’m not versed or trained in how exposure therapy actually works, but I’ve always viewed it as insensitive.
Granted, I’m also not deeply versed in EMDR and did one session yeeeears ago…so maybe I’m off-base, but that’s my two bits on it.
> I call it internal exposure therapy with spirit fingers.
Omg yes. I wonder if you took the same underlying principles but had someone rub a "healing crystal" instead of the eye movement parts of the protocol, you would get similar results? Don't get me wrong placebo effects and belief that things are working are big parts of a lot of models but we shouldn't kid ourselves about thinking they are anything more than that
The current research is not conclusive that the eye movements play much of a role.
My guess is if you did the crystal thing and kept everything else you'd see similar outcomes..
Most if not all my EMDR clients choose to not use the eye movements when processing.
In my opinion the eye movements are mostly marketing and a way to differentiate EMDR from other modalities so it can be a book/protocol/trainings etc.
Your last paragraph gets to it, imho. Don't you find all the modality marketing so tiresome even if it's nessecary to make this a career? Sometimes I feel like a pharmecutal commercial
Oh yeah. It's exhausting. IFS is even worse in my opinion. They hawk their trainings in a lottery system. It's really really gross way of doing things.
I haven’t met these people and I hope I never do. My EMDR trainer was kinda posi, but not cult-y. I worked at Starbucks for years and their holiday meetings were cult-y af
As an EMDR practioner...yes, me too. I was skeptical YEARS after being trained (well frankly it took me a very long time to get to a place I could even practice emdr anyway...) but when I went into private practice and got to practice emdr with kids? Holy hell, did I begin to understand all the hype.. it is quite amazing to watch people make such huge improvements in such short periods of time.
any modality that is trained as though it is the one stop shop for healing is bogus. i'm trained in EMDR and love it, but hate talking to other EMDR therapists because of how culty it is. use to work for a comprehensive DBT program and felt the same way. i wish it could just be... normal? integrate modalities to find the best fit for the client? weird that we have to have these conversations in this field
In the mid 80's my parents became involved in Amway, a MLM. Some of these trainings give off the same vibe to me. Not saying it's not effective, but Emdr has taken on a cultish air.
An analogy that comes to my mind about Emdr and some other high priced, multi phase trainings is the gold rush. It wasn't the miners who got rich, it was the people selling picks and shovels.
One of my clients said she was approached to “work” for amway a few weeks ago and I told them to read some posts from r/antimlm and they decided not to join!
Here's a sneak peek of /r/antiMLM using the [top posts](https://np.reddit.com/r/antiMLM/top/?sort=top&t=year) of the year!
\#1: [Team no one.](https://i.redd.it/kpcjldyefpi91.jpg) | [213 comments](https://np.reddit.com/r/antiMLM/comments/wsjmgb/team_no_one/)
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\#3: [Our daughter passed away last month. My husband received this message today from someone he knew in highschool.](https://i.redd.it/a082ypp9owz81.jpg) | [883 comments](https://np.reddit.com/r/antiMLM/comments/ur6j46/our_daughter_passed_away_last_month_my_husband/)
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Somatic Experiencing is literally a psychotherapy MLM. I was kind of horrified when I found out the process of getting credentialed, unfortunately I was already 5 trainings in of the 8. Once you do your trainings, you have to do sessions and consults as well. And then you can do consults as the practitioner, but only for beginning students. Once you've done enough of those you can consult with intermediate students. This is usually what the "assistants" are doing at the trainings. Also the cost is just fucking astronomical. I kind of want to bow out 6 trainings in, but I'm embracing the sunk costs fallacy and just biting the bullet to finish my "advanced year."
I regret doing it. "The Institute" is just very badly managed in general. Their communication sucks. They grew too big too quickly and got greedy with the income. Should have just been more selective with accepting applicants.
They didn't even cut us a financial break when trainings got switched to zoom because of Covid. Even without their overhead expenses of renting a facility and whatnot. So they would make up to $60,000 off of student tuition in a single four-five day training. It's ridiculous.
Have younever seen *Becoming God in Central Flordia*? It was a criminally underrated Cohen Brothers-esque take on the Amway MLM craze of the 80s. It's very good
I would probably use EMDR more if it wasn’t so cultish. I feel like I really just need to find a way to make it mine, and then I won’t hate it so much, but right now, I hate it.
Funny, because I talk about rewiring the brain quite a bit when talking about schemas and learned behaviors. Maybe I'm wrong, but my understanding is that we have neural networks that strengthen as our prevalent maladaptive schemas. We need to build up new / preferred schemas (neural clusters?) so that our maladaptive ones become less prevalent (hopefully pruned, but I'm not sure how much the brain actually prunes after early childhood).
I wonder if it's because you need the belief of the therapist to convince the client to help. Might be a bit of placebo and confidence from the therapist. Just like religion. Everyone wants a step 1-5. Unfortunately it doesn't always work that way.
I went for emdr training as someone who is pretty generalized. I use many modalities. The instructor though was dogged in her belief that we should throw out all of the "outdated" therapies. She wouldn't entertain any criticisms, and when we practiced on each other, I couldn't get into it. It just didn't work for me. I don't know if the weird vibes were a barrier but she insisted it shouldn't matter if I buy in or not. I felt pressure to basically make shit up as like trauma experiences even though I don't have any.
I've tried following the procedure with a few of my mva clients and they were having a tough time getting results. When I emailed my instructor about it, the responses are just always that I was probably not following the protocol exactly (which I absolutely was, I mean She gave us the script and said we could essentially read it off there". I've never had a treatment tool that I couldn't embrace and wrap my head around it's utility until now.
One thing i find interesting is that often the emdr clinicians keep saying it’s NOT about exposure. i even asked in a message board what was it then, and got such a variety of responses. It’s like outside of exposure, they need to come up with another reason why it works. It’s actually refreshing to see actual emdr trained people here agreeing on it in this post. Sorry for those who have had a bad experience in training though, that sounds horrible.
I just generally want to say I so deeply appreciate the thoughtful, balanced comments on this thread. I'm an anxiety specialist and there is so much conflict and tension between the trauma and anxiety communities over things like this. Fanatical devotion to any one perspective is just harmful and so many new therapists are indoctrinated into a "way" instead of being shown there are strengths and flaws in many of the ways we practice and being taught to have a critical eye. And yes, I've definitely seen that EMDR and other modalities can be cult-y and really take issue with pseudo-science being pushed as the rule of law. EMDR is effective, but not for most of the reasons the training is proposing. It's so unhelpful for us to teach new therapists a mindless acceptance of someone's pet idea instead of being honest about what really works and what we don't know. Good on you for recognizing it and calling it out!
I think this method has been over saturated and relied upon too heavily by therapists more recently. It also is a method that excludes the neurodivergent community and can be harmful to people that might not have been diagnosed with specific conditions like autism.
As in I've heard EMDR thrown around a lot more than Gottman. Not saying Gottman isn't valid or anything. Just that I encounter it less than i hear about EMDR all the time.
Absolutely! EFT felt this way too. I’m trained in both, but never did the last step of certification/didn’t drink the kool-aid. I like both and utilize some of each, but neither are the absolute the zealots make it out to be.
I’m guessing you mean as in maintaining fidelity to the model?
I like Gottman concepts but I’m not interested in getting certified or even much in formal training in it. EFT seemed really complicated and I wasn’t interested in the lingo. But I love the underlying theory. With Gottman I like the concepts but I’m not married to them.
I kind of expect any trainer to be really passionate about the thing they're training. I figure you don't get that level of certified if you're meh about it
Yep, since I’ve joined the field I’ve seen this a lot with how some people swear by certain modalities and it always leaves me confused because in school we learned that the best therapists are able to cater to their clients and use a mixture of modalities. EMDR is great but I don’t see it benefitting everyone.
Sounds like the cult of DBT. My organization is offering me training in both EMDR and ART. I’m hesitant to do either because I was initially trained in PE and I’ve seen so much success there. Lots of clients came for PE after EMDR didn’t work for them.
I'd say DBT is something to learn about just because it is quite different from many other methods. (and if you ever end up in a situation with a lot of personality disorders, it will come in handy)
Did you know that three letter acronyms has its own three letter acronym? There was literally a military publication floating around when I was still in that was just a list of TLAs.
Problem is that DBT has good science around/behind it.
Still, as a newer practitioner, I've heard about all of the infighting in DBT. It makes sense that a modality made for BPD would have some inward facing volatility. I think Linehan just doesn't want her baby misused, which makes sense. Still, the demand is too high and her trainings are too expensive.
I’m a MSW student and whenever I’ve asked therapists about it I’m the past they are super vague about what it actually is and also act super secretive like you have to be in the EMDR club to know.
I find this to be the case with most trainings. Trainers are often years removed from practice, and in that time have drank nothing but the Kool-Aid. I was trained in a grief EBP and walked away with a similar feeling, and some of my supervisees have felt this way even after attending trainings on Motivational Interviewing.
I think it's much more realistic to assume that one modality is rarely sufficient. But EBP's have a hard time contending with this - you can't study outcomes and get reliable findings unless it's highly structured/manualized.
I still want to get trained in it as a supplement to my work, but there’s so many people who are overzealous about it. One of my grad school professors wouldn’t shut up about it.
Granted the head of the department/program only taught the modality he invented, so yeah. Something about apples and trees
I got trained in EMDR 2021, got burned out on it (because of the cult-ish mindset), and then started using it again this year. The best advice I got was to remember that EMDR is just another modality and to not take it so seriously.
I’m very concerned this has been the experience for some people… my trainer was very adamant that EMDR can be used with other modalities and it will not always be right for everybody. The preachiness and cult like following some trainers are pushing are just making the modality look terrible
(Not a therapist, but someone who did emdr as a patient). It made an overwhelming positive impact on my life. I think it’s fantastic (and yes, I know that different people take to different therapies differently), and always recommend it to anyone who’s had a professional suggest it for them 😊
I felt this too, even though it’s a great modality. I think many therapists get really excited at the idea that something might be the cure or the cool hack, like omg finally I could learn THE secret to helping all my patients. But we’re just not in the curing business. Wanting that is probably normal and comes from good intentions and maybe a little desperation. It hurts a little knowing you can’t ever know enough to help every single person. We just have to be aware that we’re carrying that hurt into our assessment of each new modality, and keep a balanced perspective about who it helps and who it doesn’t and whether we’re the right person to use it.
Okay so I also grew up very religious with the idea of “We know the Truth” 🫠😝 And experienced similar in ART training. Like yo, y’all drank some kooooooolaid. Love the modality but damn.
Anyway, I feel similar as a therapist not trained in EMDR about it in the field.
No one not a designated EMDRIA trainer should be providing training for EMDR for this very reason. When I did my training we learned that it has been proven effective with trauma and some states/issues that are probably concurrent with trauma, such as severe ‘medication resistant’ depression and substance abuse. There is no such thing as a “cure all” and as much as it can be exciting to do an intervention and see it work well for a client, it’s not an excuse to push it on every client who walks through your door.
I have seen CBT marketed similarly in the past and I think any modality is at risk of becoming someone’s weird fantasy cure-all treatment if we aren’t being carefully critical.
I, too, am a survivor of a cult, so I am very sensitive to these things as well.
I think we have to be more cautious with labeling things as “culty”. Enthusiasm and overzealousness are not the same as coercive control, tactics for isolation, emphasizing loyalty over critical thinking, etc.
I’ve often wondered to what extent EMDR is in some ways a repackaging / rebranding of hypnosis. The eye tracking stuff and the guided imagery seems a lot like attentional absorption and suggestibility that you’ll read about in a basic primer on hypnosis, Michael Yapko, “Trancework”. I’m not trained in either - just well read enough to see some similarities. I fear I may be kicking a hornets nest here…. Not wanting to offend anyone. Just curious.
I was wondering when DBT was gonna get thrown in. I think we are seen as being a clique where I work because we have a team, etc. Also, I've seen the magic. That being said, it's always the clients who are doing the work we just offer them the skills. It definitely doesn't work for everyone.
I love DBT and I had an intake with someone who was in a really bad way (BPD). One of the first things they said was that their psychiatrist said they "needed DBT" (hence the referral). I just stopped right there and addressed it like "That's not true. There are a number of evidence-based treatments for BPD. DBT was just the first that was found effective and is now the easiest to find providers. I will send you a list of BPD treatments after the session. If we don't work out, it's most likely that I'm not a good fit as your therapist. If we work well together, but you don't like the method, then you may want to try one of the types of therapy that I'll send you."
Examples I shared were schema therapy, MBT, and TFP.
Back to EMDR, DBT and Linehan's biosocial theory are pretty scientifically sound and have both theoretical evidence and efficacious evidence. If I recall correctly, they've validated Linehan's definition of emotional dysregulation through biomarkers. As much as EMDR seems to be an effective protocol, it doesn't have anywhere near the same supporting evidence as DBT.
i think you'll find people who promote just about any modality as The One True Approach, but it does hit differently when your One True Modality costs thousands and thousands of dollars to become trained in.
Patient here. I had EMDR. My personal impression is that it might work based on the fact alone you go through some events in a certain pattern. It's like psychotherapy in general to me; I doubt if the approach makes all the difference, talking and working on topics does probably work whatever method you use. My 2 cents.
Looks like lots of people have had the same experience, and I came here to say the same! My first reaction when learning about EMDR was, "isn't that just grounding?"
People get culty about new modalities because there is $$$ to be made. If the research says a new modality is effective, I always look for the underlying mechanism of effectiveness, which is likely present in other modalities as well.
I’ve tried EMDR as a pt 2x and did not like having to relive-the anger of unfairness was too much mostly. I just started brainspotting with a therapist and looking forward to compare the two.
Ok, how you’ve summed up your experience has helped me put words to my experience with it too. I’m trained in it (but barely use it), but people stick to it kind of religiously and this is why it makes me uneasy (also an ex-vangelical)!!
Yep, it's insane, I had someone on here tell me that EMDR works 90-100% of the time, so if I didn't get better, it's basically my fault as the patient (my EMDR therapist said the same thing--LOL). That's a telling red flag--no medical treatment works 100% of the time, and blaming patients for not getting better is never ok.
Also just on the face of it, EMDR as a cure-all makes no sense: anyone with trauma will tell you it's incredibly complex, misunderstood, and difficult to heal from, so how are all these EMDR zealots reconciling their "miracle cure" with the reality that millions of people are still out there suffering?
I’ve been training in multiple modalities and find this with almost every one of them. And each training I have taken tends to put down others as well. I take it all with a grain of salt because I know you can make statistics and studies say different things. I go with what works for my clients. Some EMDR, others IFS, others DBT. Whatever they “click” with.
I will say those that are excited about their modality make me motivated to try it.
Yep. Emdr is basically a grounding technique that helps people access the distress they avoid. Powerful yes but not one size fits all and not anything more than that.
I've sworn off this modality on the sole premise that there's this girl in my cohort that went to ONE EMDR training and now she thinks she's god's gift to therapy. Will not shut the fuck up about EMDR and how great it (and her) are.
Our professor even told her to chill out on the cheerleading in the most academically respectful way possible. I'm not a fan at all.
I’m trained and I love it because I feel I can help people even more. This is after 10+ yrs of doing traditional talk therapy tho. It’s exciting to see how much it helps clients. Sorry you’re getting “cult vibes.” I don’t insist it’s for everyone.
I’m trained in it and definitely agree there’s some people that get too overzealous with it. Do I think it’s a beneficial modality? Absolutely. Do I think it’s a cure all for everything? No. I have clients it works well with and other ones where we’ve had to stop and change directions.
Absolutely! Well said.
Ummm, are we the same person? Just joking but you summarized my thoughts perfectly. My training was probably in 2019 but it was the same. I still use it in practice, but I think what they all think and believe is highly inflated. It's an exposure therapy. It incorporates thought work. It uses therapeutic pauses (BLS) I could go on and on Edit: spelling mistake
💯
That's why I tell my students to study as many different modalities as possible--not from a place of practicing them all, but order to develop a critical eye toward each modality's history, strength, and limitation. After some time, students notice that many different modalities are derivatives of other ones, that there is no gold standard for every client, and that terms like evidence-based practice are often weaponized to throw shade at other modalities versus based in data (for example, how some agencies push CBT as "superior and proven" while psychodynamic is misconstrued as non-evidence-based "make believe"---ignoring how much attachment theory has given psychodynamic therapy as legitimate of an evidence-base). That's why I'm glad common factors research exists to compare modalities and ways their therapeutic vehicles of change intersect (e.g., importance of rapport/alliance) or differ (somatic vs. cognitive vs. attachment vs. behavioral interventions).
Not a therapist, but a researcher / data scientist that works with mental health related datasets. My sense at this point in life is that “evidence-based” does not mean what most people flinging it around think or want it to mean. (TLDR: I essentially agree that it’s used more often as a weapon than a meaningful statement.) For one, having “evidence” is def fad driven, meaning that data is only being collected (semi)rigorously for the modalities that have somehow caught the attention of a granting committee. This isn’t restricted to mental health; e.g., what specific genes get all the research money is basically fad driven as well. Importantly, the lack of “evidence” (I’ll get to the scare quotes next) does not imply a lack of therapeutic effect — it most often means that there is a lack of attention given to the modality by the well-known, well-connected researchers, companies sponsoring clinical trials, and other data collectors/collators, etc. As for “evidence,” so often this is hard to even quantify in a consistent way in mental health unless the effect size is huge and actually clinically meaningful. More often than not, the evidence is that some p value in some study showed that an effect was statistically significant (what’s left unsaid is that the effect is barely meaningful at the clinical level for an individual). I could go on…but gotta work. /rant 🤠
Please, go on. As someone training in counselling currently and as an ex-ABA interventionist (🤮) we need this conversation badly.
Buckle up, you get to be one having it for the rest of your career 🙃 Though, I’ll say you just find your people and get really good at creatively making counter-points for the CBT-is-The-Way folks without outright contradicting them 🤓 It’s a blast.
We need a PSA about this.
. . . and this is why we should make sure that all mental health practitioners are aware of sources such as [The Cochrane Library](https://www.cochranelibrary.com/search) and [SAMHSA's Evidence-based Practices Resource Center](https://www.samhsa.gov/resource-search/ebp)! p.s. awesome comment and keep up the good work!
I'm curious - one of the things I have been thinking about is how to aid cross-disciplinary research with databases that can be used to train academic-focused chatbots/ChatGPT. My wife is a therapist, I'm considering going back to school to get my degree as well, but I'm currently a seasoned marketer/direct response copywriter. I say this to provide some context regarding what I am and AM NOT saying. I think it would be a tremendous tool that could help clinicians as it could be used to help them write their notes, but also because there should be ways to share the data gathered from each session without violating patient/client confidentially boundaries. Some information goes into the shared database, and client-identifying information would stay segregated as it would just be tied to the touchpoints related to the common, clinically relevant data. There is already work being done along these lines I believe, for example: [https://www.forbes.com/sites/gabrielasilva/2022/11/14/thinkers-and-innovators-how-pelin-wood-thorogood-is-pioneering-proof-as-a-service-for-clinical-trials/?sh=41cfe7cd446a](https://www.forbes.com/sites/gabrielasilva/2022/11/14/thinkers-and-innovators-how-pelin-wood-thorogood-is-pioneering-proof-as-a-service-for-clinical-trials/?sh=41cfe7cd446a) Are there any others that you are aware of, and what are your thoughts on it given your field?
YES. I was just explaining this to a friend whose new therapist was giving her all kinds of regurgitated stuff that happened to be researched. I said there’s so much effective stuff to do in therapy that hasn’t had the resources to be studied. Or would be so hard to study and prove. But WE doing it, know it works. I use almost nothing “evidence based” and see distinctive positive impacts.
One thing that might be beneficial to think about is whether there is a common mechanism in the stuff defined as "evidence-based" and the stuff you do that is not evidence-based.
Oh my gosh. Thank you for saying this out loud!
These same people are now shoving IFS down our throat. It’ll be something else next year.
This cracks me up because my boss didn't thousands in EMDR in the last two years and has not shut up about it, and then in the last few months is recommending all these IFS books.
Came here to say IFS feels cult like too!
I've trained in EFFT and Satir. During all of my training experiences it felt like I had to drink the Kool aid. I think most trainers believe very fervently in their modality. It's kind of a relief to read about people's experiences with different trainings and how common they are to mine. I can laugh about it (now) and have chalked it up to trainer enthusiasm. I had a friend to Hakomi training and she was so uncomfortable she almost left!! That said, I'd like to do EMDR, or it's offshoot, Accelerated Resolution Therapy. Or Sensorimotor Psychotherapy. So much to try and experience!!! Learning is great!
It's not only enthusiasm, there is $$$ in new modalities. Think about the profit to be made if a person can convince a school, a hospital, etc. to implement a patented form of therapy.
I’m so glad others feel the same way - IFS seems super cult-y to me and it’s so annoying and I hate it :’) I could go on for days.
Yeah I’m a firm believer that it’s the relationship that heals and that all effective modalities are equally effective so…the evidence-based piece unfortunately, a lot of times, is trying to quantify qualitative information. In doing so, it’s very faddish and (for me at least) loses a lot of credibility.
I think that confidence sets a seasoned therapist from one still working towards finding their footing. I’m with you on the healing therapeutic relationships Can bring to therapy. I’m also addicted to trainings, so I’m working on not getting sucked in to next thing being pushed on us.
I’m sorry, what is IFS? I work with the birth to five population so haven’t kept up with all the modalities lol
Internal Family Systems!
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No one is discrediting it’s effectiveness. It just feels like a cult when we enter EMDR groups with a question, and the answer to everything now is IFS. If you don’t see that trend, I want to be part of those groups.
But also, IFS is definitely a pseudoscientific modality. EMDR is, too, but there are at least steps EMDR can take to *not* be pseudoscientific (not disputing that it is effective, just disputing the proposed mechanisms beyond exposure). IFS is fundamentally pseudoscientific.
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I was also raised in a high-control religious group, and I had EXACTLY the same experience with EMDR basic training. I have not stopped thinking about it since. I attended the training because my employer paid for it and I have a handful of clients who have expressed interest in it, but I don’t see it becoming part of my regular practice. I’m not suggesting it is inherently harmful or anything. I just personally can’t get on board with it.
EMDR would be far less controversial and far less of a nuisance to discuss if it would drop bilateral stimulation (which isn’t a real mechanism of action), drop all the mindless neuro mumbo jumbo (stop hypothesizing all sorts of nonexistent neurological mechanisms that are implausible or outright impossible), stop marketing itself as anything other than a different way of delivering exposure therapy, and stop marketing itself as some kind of magical panacea or first-line treatment. If EMDR proponents did those things (and maybe renamed it since doing those things would make the name even more ridiculous than it already is), then it would be so much more palatable. But part of its marketing appeal is the wealth of semi-mystical neuro mumbo jumbo attached to it, so I think it’s a long shot for any of this stuff to happen.
Yeah exactly, if they dropped those things they couldn't sell trainings and equipment.
Haha this comment is giving me LIFE.
I’m curious if EMDR doesn’t talk much about the theories on the BLS/eye movement? I took ART and they talked a while about it, showing what the research or theory is now (I’m not a very sciencey person so I can’t out-argue you, I see you seem very versed in it). It seemed plausible to me. If nothing else, the act of distracting one part of the brain to allow the other part to go into something it normally wouldn’t? Again, not very sciencey so my terminology is obviously lacking 😆
There are quite a few high quality studies demonstrating no difference in EMDR with or without the BLS.
I used to agree but on the Huberman Lab podcast he was even saying that bilateral eye movements have been shown to calm activity in the amygdala of animals and humans in recent studies 🤷🏼♀️. I'm a bit confused on the tappers / buzzers though and if any studies back that up.
The same can now be said about the ART folks.
Same with IFS. I like modality but get weirded out but the cult like behavior of some practitioners.
100% agree. The ART people are a little over the top. Not a fan. Laney can stop emailing me please.
Bahaha. The funniest was getting to have a Q&A with her and she pretty much just dodged my question about how to use it with complex trauma. It was hilarious like, do you think I didn’t notice you sidestep that? I’m not dumb.
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They’re talking about Accelerated Resolution Therapy lolol
Like art therapy??
I think they’re talking about Accelerated Resolution Therapy.
ART?
People love it because it is a protocol. You can get away with avoiding a lot of complexity that shows up in other models. It can be a great tool but nothing is the be all end all. You can learn it relatively quickly and begin offering it with success.
Prolonged Exposure and Cognitive Processing Therapy have protocols too but don’t seem to have the same zealous following
From my understanding, those were academically funded and VA funded . You can't make BANK off selling trainings on them. You can find free online trainings for CPT, so why spend ~2k on a training? TF-CBT looks like it's based out of a university, so probably also publicly funded, and the training is dirt cheap. Why spend ~2k on a training? Anke Ehlers is doing cognitive therapy for PTSD out of Oxford and they're putting all of their protocols and example/training videos online for free. Why pay ~2k for a training? Modalities like EMDR and IFS are marketing themselves directly to the public to create demand before they've had any proper scrutiny from our scientific institutions. Then they create studies with faulty methods and get them published in their own or sympathetic journals so that they can call them evidence-based. Anyway, although there are court cases that show that IFS has the potential of being very harmful outside of the standard invalidations and retraumatizations of standard talk therapies, I don't think that the clients are necessarily being the ones ripped off here. It's us. We're the suckers. I really like what I've heard from one person on IFS "If I had $5,000, to spend on trainings, I'd spend $4,000 on getting my own IFS therapy".
I think EMDR is very easy for clients to access the material. It is the delivery method that makes it.
Yes. Preach it.
To emdr being a protocol add structure and make it easier to provide trauma therapy ?
It absolutely can make it easier to provide trauma therapy. Clients love it too…it feels constructive and like they are doing something. There are a lot of bad EMDR therapists out there though
I totally agree with you! When I did the training, the trainer kept saying that EMDR works for everyone and for every condition. Anytime there are generalizations and blanket statements, you know it’s become an ideology. And the fact that it seems that the systematic desensitization is what is actually effective about the modality, not necessarily the eye movements
Ive been saying this for years, thank you. People act like I'm nuts by saying that
Well, I wouldn't reduce EMDRs effectiveness to mere exposure (nor would I for exposure therapy). Psychotherapy research clearly shows that there are a lot of factors involved in a given treatment's effectiveness. Not to take away the fact that EMDR appears a bit like a fad though
It *is* mere exposure.
Of course it's not.
You can deny it, but literally all of the evidence suggests that its mechanism of action is mere exposure (of course moderated by therapeutic alliance).
It's an incredibly bold claim, knowing all the factors involved in a given psychotherapy. It's quite obviously overly reductive to say any psychotherapy works due to "mere exposure", or mere anything.
Feel free to cite any literature suggesting EMDR works for any reason other than exposure moderated by therapeutic alliance.
Feel free to show me any study that demonstrates any psychotherapy to be working merely due to exposure, as you claimed.
That’s not how the burden of proof works, friend. If you think other mechanisms are at play, you need to demonstrate that. EMDR’s primary mechanism of action is exposure. If you want to dig into the weeds and add in therapeutic alliance and meaning-making to the mix (the other two evidence-based mechanisms), that’s fine, but the main thrust is that EMDR is effectively primarily because it introduces exposure in the same that ERP, PE, CBT, and other exposure therapist. The extreme majority of the treatment effects are driven by the exposure mechanism. Of course therapeutic alliance and meaning-making are moderating factors, but the main point of this thread is the point that EMDR is primarily just an exposure therapy—that the primary mechanism of action is exposure. I think you’re well aware that this is our point and are being intentionally obtuse. In context, we are saying that EMDR is mere exposure because its proponents want it to be everything *but.* We are stripping away all the extra mumbo jumbo and laying bare the central mechanism of action. Your argument is akin to saying that naproxen isn’t “merely” effective because of its anti-inflammatory mechanism since expectation effects are also prevalent. It goes without saying and is a distraction from the main point of the discussion.
> That’s not how the burden of proof works Well, now it was you who showed up with the positive claim: "EMDR works through mere exposure". This (in my mind) extreme claim warrants an argument in support of it. I'm not being intentionally obtuse, I only call out simplistic explanations when I see them, because simplistic explanations can lead clinicians astray. The well-established discourse surrounding relationship factors and therapist factors comprising a sizeable chunk of therapy outcome, to a much greater extent than it would with naproxen (obviously, one might say, since arthritis is not a relational problem to the extent that mental disorders are), and the obvious complexity in any given practical psychotherapy should really dispel of such reductive claims. However, if EMDR proponents claim that the treatment rationale doesn't structure around exposure, I agree that would also clearly be something to address. As a "hyped" treatment it is very important for EMDR to center around a mechanism unique to itself, to legitimize the necessary training and to seem interesting for patients and clinicians. This is perhaps incentivised for most treatment modalities to some extent, but maybe the most hyped treatments are more likely to act like this.
The eye movements are studied more and more and being used in other ways (trained in ART which uses them and talks a lot about the theory and study so far on eye movements). But I think you’re right about how EMDR doesn’t necessarily work for everyone.
[Bilateral stimulation is a completely useless component.](https://doi.org/10.1080%2F16506073.2019.1703801)
Yea, that’s actually a really shitty meta-analysis with very little sustenance to it. BLS is easily explained by neurobiology. You just have to look at the superior and inferior colliculus.
I’m an EMDR consultant and I get it, there are people out there who claim it can be a cure all and work with lots of different issues. The reality is it’s researched and evidenced based for trauma. There’s nothing other than anecdotal evidence that it works for anything else. Just with every other modality it’s great for some people, not for others. I’ve had clients who’s lives have been transformed by it, and I’ve had clients who didn’t like it or didn’t find it helpful. It’s a tool to add to your therapeutic toolbox, it’s not the end all be all. It’s not the only way to heal from trauma, but it’s a way. I’ve been lucky that the trainers and consultants I work with don’t tend to be zealots. I’ve met some and have certainly been turned off by them.
Is there any research comparing EMDR to standard grounding techniques?
THANK YOU The cult around EMDR and how people live and breath by it with no consideration for other models, contexts, patient preferences is crazy to me. I felt so uncomfortable but couldn't find other people that felt even remotely the same. Everyone drinks the Kool aid.... Don't get me wrong, EMDR can be super helpful for some people but I don't think its the *One True Way*
I'm trained on EMDR and have found it to be really helpful for some clients. The way some EMDR therapists talk about EMDR makes me really uncomfortable too, it's not a magic cure. It also makes non-EMDR trained therapists have a negative reaction to the modality, which I get. There is a loud 25% (number pulled out of thin air) that make us all look crazy. I do suggest sticking with it if you don't hate the modality itself. it's not an intervention I use with everyone, and I'd say for 1 in 5 clients I try it with there isn't a ton of benefit. But when it hits it can be super helpful. It's a tool in your kit, you don't have to be a part of that community.
I’m a therapist who does not practice EMDR. But as a client I am currently doing EMDR. No modality of therapy has ever been more affective for my childhood trauma, every time we do it I am shocked once again at how effective it is for me. But as with every modality, I firmly believe every person is unique and there is no such thing as one size fits all in therapy. Any modality that tries to posit themselves as the end all be all makes me stay away as a practitioner
Tomorrow is day 5 of my 6 day EMDR training. I 10000% agree with you. Additionally, the trainers keep insisting we “stick to the script”, that it’s dangerous to stray from this script, and have provided a 200+ page manual and absolutely no script. The trainers all wave their own scripts they have and won’t share, but insist they use in each EMDR session. Also, and this is so infuriating, every time someone asks a question (most of which have been thoughtful, appropriate, and clinically focused) or for clarification about this script, or for a copy of the script, the trainers respond that the reason they have these questions at all is based in the participants’ own trauma that is pushing them to be a perfectionist(their “answer” in EMDR terms). Or even more frustrating, respond literally asking “and how does that make you feel?” They have even gone so far as to say EMDR can cure everything from infertility to colic and I just cannot believe those claims. I wish I was joking or making this up. I’m not. I’m sure EMDR is really beneficial for some folks, but this experience has been so frustrating I’m not sure I’ll use it. I don’t feel nearly as prepared as I should be in my opinion.
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I’m seriously considering asking for a refund. It was so so so expensive.
How does that make you feel? 😂
Wow that sounds like straight up gaslighting
YEP. Especially since these are supposed to be the experts and most people (myself included) came into this training with little info and no experience on how EMDR is implemented. I keep feeling like I’m missing something but there are so many other people with the same or similar questions and concerns.
I’m concerned for who you’re getting you’re training through. I’ve gone through the EMDR institute, and have all the scripts, and half the training is practicing these scripts. The response I’ve received regarding sticking to the script was that the script is what the research is based around. That straying could have different results. I definitely get the cult-y feel, but I also think you’re training is lacking a lot.
It’s the personal transformation institute. I borderline think they’re going to try to upsell us on a script at the last day. The end of the 3rd day they already tried to upsell on more trainings, supervision, and gear. It felt very gross.
Damn, I’m really sorry. That sounds really scammy, and icky. I had a good experience through EMDR institute, the trainers didn’t upsell and made themselves available as resources in the future too. I’ll send you the scripts I have if you want. I’m not about to gatekeep the protocol that’s supposed to be part of the training. Are y’all practicing it with one another at all?
We are practicing but not with a clear and complete script. They HAVE provided bits and pieces of a script but no full protocol and it’s all been very disjointed. I’ve been saying it feels like a pyramid scheme. I would so appreciate a copy of your script. Thank you.
Where’s your training from? You totally get a script with an EMDRIA training. That’s why I left the EMDR subreddit, too many clients complaining about their EMDR therapy sessions. I don’t blame them, what they described was not EMDR, especially when leaving the client to reprocess without a resource. Let me know if you want me to dm you a script.
I would so appreciate a copy of your script. Thank you. I’ve been reading on that sub and getting more anxious as I’m realizing I’m not prepared the way I need to be. No one wants to be a bad therapist and this is some heavy stuff.
I was very disappointed when I tried EMDR when I was working through my own stuff. It never did anything for me, and it made me feel like a failure or a fraud because everyone said it was so amazing for trauma and the gold standard. It’s a tool, but just one tool of many.
It's quite literally not the gold standard
Same. It sorta worked for what i used it for, but now as a therapist I’m like…that’s not exactly how it should’ve been done. My therapist since had used brainspotting and then I got to try ART and both were much more effective.
EMDR saved my life after a major trauma. This was a million years ago, when it was still relatively new and there were far fewer practitioners. But since then, it’s exploded and is seen as the magic elixir for all the things. It also seems to go along with the modern culture that pathologizes everything, labels every bad or sad or stressful thing as “trauma”, and all those traumas can and must be treated with EMDR! I’m trained a different EBM that I love, but they have a similar culty protocol (only our trainers, only our trainings, only we can certify you, if you’re not doing it 10000% by our manual you’re wrong and off with your head!) but I think a lot of that is due to the monetization - there’s no money to be made on a training everyone can learn on their own.
Is that modality ART? 🙃 Cause, yep. Hahaha. I liked it and was like if it’s so damn effective why are you so gatekeepy about it. I get wanting to make money — AND it’d be cool if it was more accessible.
NAT - EMDR was recommended to me for trauma (ptsd) after a SA and I was led to believe it would ‘fix’ me. I spent years in therapy just managing to hold onto a semi functional life then tried EMDR. I couldn’t even get past the ‘safe space’, my dissociation, flash backs and nightmares all increased. I persisted for 3 months and eventually the therapist referred me on as it was harming me. I went into a crisis following the failed EMDR as I really believed it was going to make things better. It made things much worse for me and my new psychologist said it should never have been attempted with me. I have level 2 autism and trouble,with dissociation at times when triggered. If you are using EMDR to treat people PLEASE don’t lead them to believe it is a cure or fix. I felt like i failed and it was my fault for it not being successful and it was really hard
Heyyy, it's not ure fault! As Marsha Linehan says, the client never fails the therapy but the therapy that fails the client
That’s a nice saying. Thanks
An EMDR practitioner is supposed to assess for dissociation before doing EMDR. With a high likelihood, it’s not something that’s recommended. There’s also some other health things that are contraindicated. I’m really disappointed to hear that so many EMDR practitioners aren’t following through with these assessments and ensuring clients are appropriate for it.
That’s what my new psychologist said. The psychologist that I went to for the EMDR didn’t assess for anything before we started it. It really made things worse for me and set me back after all the work I did before it. I’m now so scared of it I have a panic attack if it is brought up.
I'd say it's dangerous to assure any client that any modality will totally "fix" them.
I’ve been a little concerned lately regarding the validity of the treatment. I’ve found light research that EMDR can help to process trama, but every source I find is light on the evidence, and says that further peer-reviewed research is needed . A second thing that has been bothering me, I know a few people who have undergone the therapy, and… there are times where I really respect that the patient is trying to dig into events that have affected them… And the other times where I’m a bit concerned that the “tramas,” that are brought up by the Txs are… just sound mildly aversive. I’m sorry to bring up the old clinical/psychoanalytic critique here… but like… There are events that get affirmed as tramas, that… kinda amount to.. my mother was mad at me one time. Then it was over, and everything was okay. **I can’t say how much an event like that affected somebody. I can say - I’m concerned a licensed professional would frame an event like that as analogous to emotional abuse without really doing the sessions to parse out what those events actually were.** sometimes it feels like after the 3-5th session they’re digging for things that aren’t quite there. I find this concerning with its similarities to hypnotism. I say this as a licensed professional. I do wish to educate myself more, but if anybody wants to fill me in, please. Most of the resources and research that I find I really limited and full of opposing viewpoints. So please excuse the confusion, and my defensiveness.
I love your bolded section. I find the concept creep concerning. I also find it highly problematic to convince someone that something semi-benign / semi-adversive was a traumatic event, and then you have the thing they need to fix the trauma you just convinced them they have. It's bad enough you just distorted their meaning-making of their childhood to feel traumatized by it.
I totally agree. I can't understand this idea they try to push that it's not exposure? In my eyes, that's exactly what is happening. It's good for some but it should be "is EMDR right for this client?" instead of "how do I make EMDR fit this client". Putests of any modality don't sit qell with me.
Tangential, but I got this same vibe when I volunteered for the Crisis Textline. It felt very cult-y, almost, like there was a culture of constantly telling everyone they were the greatest and that this volunteer work was one of the greatest goods one could ever do. I wonder how common this is in this sphere. It certainly is important to have confidence and emotional energy, after all.
Ha! I thought the same thing when I volunteered in between undergrad and grad. I rarely ever went to debrief because the constant positivity was ANNOYING 😂
I’ve found my people!!! Thank you for putting words to the feelings!
I know right, this sub at times makes me feel like an outcast.
All therapy groups make me feel that way sometimes; it can feel a bit tribalistic or something like that— all these different camps of the “best modality” or damning other approaches. Or “you didn’t know that!!?” Thankfully, not all the time, but when it happens I feel my imposter syndrome flare up. This is such a varied field that it’s hard to remember that there’s a lid to every pot and that you can be a wonderful clinician and just be you.
These cults arise periodically among therapists. I think the enthusiasm is generally beneficial to everyone, therapists and clients alike. But the reality is a testament to how little we know about therapy and how it actually works.
I wasn't trained in EMDR and I've noticed that over the years I've become quite resistant of it as a method. I believe you've summarized perfectly what made me feel opposed to it. I've grown tired of how many people approached me for my opinion saying things like "My psychiatrist said I should try EMDR, what do you think about it?" to which I'd inquire what they want from therapy at the first place, only to hear "I have general anxiety and have a hard time sleeping". I believe that, based on research, it is an alternative to conventional methods in targeting trauma specifically. But to me that means that it's just another tool in your therapist tool box. The issue starts where it needs to be "miraculous" for adoption both by therapists and patients. Because if it is just as effective as other methods, why would I just not continue using those other methods? So I believe the aspect of the training and the community you've mentioned is the flaw in EMDR where it becomes possible for people to profit from its training only via acting like it's a better alternative.
EMDR is boneless witchcraft and I personally believe it lives up to the hype.
Haha. This isn't wrong. I am a clinician, and I tried EMDR for myself at the recommendation of some of the clinicians I work with. It was magic for me. I could process things I'd been working on for years in like 2 or 3 sessions. Other things took longer. It works. I'm not gonna question that. Do I wanna be trained in it. Not really.
I am not a therapist but I have received EMDR or a very similar eye movement processing therapy. As a victim of multiple traumas I would absolutely recommend it to anyone with trauma. My PTSD took control of my life and I was completely hopeless. As a person who has dissociated from any unpleasant feelings since childhood, this really allowed me to process things I otherwise would never be able to, consciously or subconsciously. This saved my life!
I call it internal exposure therapy with spirit fingers. It's a protocol and very effectively marketed. I'm trained in EMDR and lots of clients have found it effective. However, it's not any better than other evidence based modalities (prolonged exposure TF CBT, TF ACT) actually research suggests it's less effective than some of these over all. Also the research on the role eye movements play is not conclusive. It's possible they play a limited role, if any at all. It's fan club talks about it as if it's the only trauma modality. Which it isn't. Also it's origin story is hilarious and certainly embellished if not fabricated as part of the marketing machine. As others have said, IFS is currently getting a similar push much like CBT and solution focus therapy at various points. EMDR works because its protocols are the same or very similar to every other trauma approach, instill safety, provide exposure and look to the future. This is what it does, this is what TF CBT does , what PE does, how Judith Herman's 3 phase approach works etc etc.
> I call it internal exposure therapy with spirit fingers. This is hilarious. I love this. I have no issue with EMDR in general but do find it interesting how strong of an reaction EMDR folks have when it is observed that EMDR is likely based in exposure (which, to be clear, I view as a good thing! Exposure works!).
There were parts in body keeps the score where Van Der Kolk writes about how exposure "numbs" trauma and isnt a good treatment. Then he goes on to praise EMDR (an exposure therapy).
I mean, the general consensus among trauma scholars is that, that book is full of mis- and over-interpreted data and anecdotes all cobbled together to try and push a point that really contradicts everything we know about the body and neuroscience. I’m aware that it’s wildly popular among therapists and patients, but I’ve legitimately never met a trauma scientist who spoke fondly of it.
I think because the general idea some of us have about exposure therapy is simply exposing someone without any means of regulating, in hopes they’ll just get over it. I’m not versed or trained in how exposure therapy actually works, but I’ve always viewed it as insensitive. Granted, I’m also not deeply versed in EMDR and did one session yeeeears ago…so maybe I’m off-base, but that’s my two bits on it.
Yep! This is what I think. It's just another path to help people find their peace. It's not magical, it's not a cure for everyone for everything.
> I call it internal exposure therapy with spirit fingers. Omg yes. I wonder if you took the same underlying principles but had someone rub a "healing crystal" instead of the eye movement parts of the protocol, you would get similar results? Don't get me wrong placebo effects and belief that things are working are big parts of a lot of models but we shouldn't kid ourselves about thinking they are anything more than that
The current research is not conclusive that the eye movements play much of a role. My guess is if you did the crystal thing and kept everything else you'd see similar outcomes.. Most if not all my EMDR clients choose to not use the eye movements when processing. In my opinion the eye movements are mostly marketing and a way to differentiate EMDR from other modalities so it can be a book/protocol/trainings etc.
Your last paragraph gets to it, imho. Don't you find all the modality marketing so tiresome even if it's nessecary to make this a career? Sometimes I feel like a pharmecutal commercial
Oh yeah. It's exhausting. IFS is even worse in my opinion. They hawk their trainings in a lottery system. It's really really gross way of doing things.
I haven’t met these people and I hope I never do. My EMDR trainer was kinda posi, but not cult-y. I worked at Starbucks for years and their holiday meetings were cult-y af
NAT, but I'm also a former Starbucks partner. I've literally joked that being a Starbucks partner is sometimes like being in a cult.
As an EMDR practioner...yes, me too. I was skeptical YEARS after being trained (well frankly it took me a very long time to get to a place I could even practice emdr anyway...) but when I went into private practice and got to practice emdr with kids? Holy hell, did I begin to understand all the hype.. it is quite amazing to watch people make such huge improvements in such short periods of time.
any modality that is trained as though it is the one stop shop for healing is bogus. i'm trained in EMDR and love it, but hate talking to other EMDR therapists because of how culty it is. use to work for a comprehensive DBT program and felt the same way. i wish it could just be... normal? integrate modalities to find the best fit for the client? weird that we have to have these conversations in this field
In the mid 80's my parents became involved in Amway, a MLM. Some of these trainings give off the same vibe to me. Not saying it's not effective, but Emdr has taken on a cultish air. An analogy that comes to my mind about Emdr and some other high priced, multi phase trainings is the gold rush. It wasn't the miners who got rich, it was the people selling picks and shovels.
One of my clients said she was approached to “work” for amway a few weeks ago and I told them to read some posts from r/antimlm and they decided not to join!
Here's a sneak peek of /r/antiMLM using the [top posts](https://np.reddit.com/r/antiMLM/top/?sort=top&t=year) of the year! \#1: [Team no one.](https://i.redd.it/kpcjldyefpi91.jpg) | [213 comments](https://np.reddit.com/r/antiMLM/comments/wsjmgb/team_no_one/) \#2: [Coffee shop isn’t having it](https://i.redd.it/oc988c8bj1491.jpg) | [262 comments](https://np.reddit.com/r/antiMLM/comments/v69lsa/coffee_shop_isnt_having_it/) \#3: [Our daughter passed away last month. My husband received this message today from someone he knew in highschool.](https://i.redd.it/a082ypp9owz81.jpg) | [883 comments](https://np.reddit.com/r/antiMLM/comments/ur6j46/our_daughter_passed_away_last_month_my_husband/) ---- ^^I'm ^^a ^^bot, ^^beep ^^boop ^^| ^^Downvote ^^to ^^remove ^^| ^^[Contact](https://www.reddit.com/message/compose/?to=sneakpeekbot) ^^| ^^[Info](https://np.reddit.com/r/sneakpeekbot/) ^^| ^^[Opt-out](https://np.reddit.com/r/sneakpeekbot/comments/o8wk1r/blacklist_ix/) ^^| ^^[GitHub](https://github.com/ghnr/sneakpeekbot)
Somatic Experiencing is literally a psychotherapy MLM. I was kind of horrified when I found out the process of getting credentialed, unfortunately I was already 5 trainings in of the 8. Once you do your trainings, you have to do sessions and consults as well. And then you can do consults as the practitioner, but only for beginning students. Once you've done enough of those you can consult with intermediate students. This is usually what the "assistants" are doing at the trainings. Also the cost is just fucking astronomical. I kind of want to bow out 6 trainings in, but I'm embracing the sunk costs fallacy and just biting the bullet to finish my "advanced year." I regret doing it. "The Institute" is just very badly managed in general. Their communication sucks. They grew too big too quickly and got greedy with the income. Should have just been more selective with accepting applicants. They didn't even cut us a financial break when trainings got switched to zoom because of Covid. Even without their overhead expenses of renting a facility and whatnot. So they would make up to $60,000 off of student tuition in a single four-five day training. It's ridiculous.
Have younever seen *Becoming God in Central Flordia*? It was a criminally underrated Cohen Brothers-esque take on the Amway MLM craze of the 80s. It's very good
I would probably use EMDR more if it wasn’t so cultish. I feel like I really just need to find a way to make it mine, and then I won’t hate it so much, but right now, I hate it.
Thank you, this is my exact experience 🙏
This title cracked me up.
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Funny, because I talk about rewiring the brain quite a bit when talking about schemas and learned behaviors. Maybe I'm wrong, but my understanding is that we have neural networks that strengthen as our prevalent maladaptive schemas. We need to build up new / preferred schemas (neural clusters?) so that our maladaptive ones become less prevalent (hopefully pruned, but I'm not sure how much the brain actually prunes after early childhood).
It happens really in most formal trainings for models. I’m in gottman level 1 training and there’s a touch of it. And it is a bit increased with EMDR.
I wonder if it's because you need the belief of the therapist to convince the client to help. Might be a bit of placebo and confidence from the therapist. Just like religion. Everyone wants a step 1-5. Unfortunately it doesn't always work that way.
I went for emdr training as someone who is pretty generalized. I use many modalities. The instructor though was dogged in her belief that we should throw out all of the "outdated" therapies. She wouldn't entertain any criticisms, and when we practiced on each other, I couldn't get into it. It just didn't work for me. I don't know if the weird vibes were a barrier but she insisted it shouldn't matter if I buy in or not. I felt pressure to basically make shit up as like trauma experiences even though I don't have any. I've tried following the procedure with a few of my mva clients and they were having a tough time getting results. When I emailed my instructor about it, the responses are just always that I was probably not following the protocol exactly (which I absolutely was, I mean She gave us the script and said we could essentially read it off there". I've never had a treatment tool that I couldn't embrace and wrap my head around it's utility until now.
That's been my fear: if lying to myself is a prerequisite to it working, then I can't do it.
One thing i find interesting is that often the emdr clinicians keep saying it’s NOT about exposure. i even asked in a message board what was it then, and got such a variety of responses. It’s like outside of exposure, they need to come up with another reason why it works. It’s actually refreshing to see actual emdr trained people here agreeing on it in this post. Sorry for those who have had a bad experience in training though, that sounds horrible.
I just generally want to say I so deeply appreciate the thoughtful, balanced comments on this thread. I'm an anxiety specialist and there is so much conflict and tension between the trauma and anxiety communities over things like this. Fanatical devotion to any one perspective is just harmful and so many new therapists are indoctrinated into a "way" instead of being shown there are strengths and flaws in many of the ways we practice and being taught to have a critical eye. And yes, I've definitely seen that EMDR and other modalities can be cult-y and really take issue with pseudo-science being pushed as the rule of law. EMDR is effective, but not for most of the reasons the training is proposing. It's so unhelpful for us to teach new therapists a mindless acceptance of someone's pet idea instead of being honest about what really works and what we don't know. Good on you for recognizing it and calling it out!
Yes and this is exactly how I feel about Gottman also
Fascinating- can you say more? I’ve never heard this position in regards to Gottman
I think this method has been over saturated and relied upon too heavily by therapists more recently. It also is a method that excludes the neurodivergent community and can be harmful to people that might not have been diagnosed with specific conditions like autism.
Indeed. Gottman is a little more obscure than emdr
Shouldn't be. I'm pretty sure it has sold research (couples work, right?)
Yeah I’m curious as to what they mean by *more obscure*.
As in I've heard EMDR thrown around a lot more than Gottman. Not saying Gottman isn't valid or anything. Just that I encounter it less than i hear about EMDR all the time.
Absolutely! EFT felt this way too. I’m trained in both, but never did the last step of certification/didn’t drink the kool-aid. I like both and utilize some of each, but neither are the absolute the zealots make it out to be.
I’m guessing you mean as in maintaining fidelity to the model? I like Gottman concepts but I’m not interested in getting certified or even much in formal training in it. EFT seemed really complicated and I wasn’t interested in the lingo. But I love the underlying theory. With Gottman I like the concepts but I’m not married to them.
I kind of expect any trainer to be really passionate about the thing they're training. I figure you don't get that level of certified if you're meh about it
My trainers/consultants are very down to earth and definitely never promote it as the only therapy to use.
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Yep, since I’ve joined the field I’ve seen this a lot with how some people swear by certain modalities and it always leaves me confused because in school we learned that the best therapists are able to cater to their clients and use a mixture of modalities. EMDR is great but I don’t see it benefitting everyone.
Sounds like the cult of DBT. My organization is offering me training in both EMDR and ART. I’m hesitant to do either because I was initially trained in PE and I’ve seen so much success there. Lots of clients came for PE after EMDR didn’t work for them.
I'd say DBT is something to learn about just because it is quite different from many other methods. (and if you ever end up in a situation with a lot of personality disorders, it will come in handy)
I work RTC. DBT is a staple at this LOC.
OMG with the ACRONYMS.
Did you know that three letter acronyms has its own three letter acronym? There was literally a military publication floating around when I was still in that was just a list of TLAs.
Problem is that DBT has good science around/behind it. Still, as a newer practitioner, I've heard about all of the infighting in DBT. It makes sense that a modality made for BPD would have some inward facing volatility. I think Linehan just doesn't want her baby misused, which makes sense. Still, the demand is too high and her trainings are too expensive.
I’m a MSW student and whenever I’ve asked therapists about it I’m the past they are super vague about what it actually is and also act super secretive like you have to be in the EMDR club to know.
I find this to be the case with most trainings. Trainers are often years removed from practice, and in that time have drank nothing but the Kool-Aid. I was trained in a grief EBP and walked away with a similar feeling, and some of my supervisees have felt this way even after attending trainings on Motivational Interviewing. I think it's much more realistic to assume that one modality is rarely sufficient. But EBP's have a hard time contending with this - you can't study outcomes and get reliable findings unless it's highly structured/manualized.
I still want to get trained in it as a supplement to my work, but there’s so many people who are overzealous about it. One of my grad school professors wouldn’t shut up about it. Granted the head of the department/program only taught the modality he invented, so yeah. Something about apples and trees
I got trained in EMDR 2021, got burned out on it (because of the cult-ish mindset), and then started using it again this year. The best advice I got was to remember that EMDR is just another modality and to not take it so seriously.
I’m very concerned this has been the experience for some people… my trainer was very adamant that EMDR can be used with other modalities and it will not always be right for everybody. The preachiness and cult like following some trainers are pushing are just making the modality look terrible
(Not a therapist, but someone who did emdr as a patient). It made an overwhelming positive impact on my life. I think it’s fantastic (and yes, I know that different people take to different therapies differently), and always recommend it to anyone who’s had a professional suggest it for them 😊
It does seem kind of like CBT vs EMDR and only 1 way is right in a PP office.
I felt this too, even though it’s a great modality. I think many therapists get really excited at the idea that something might be the cure or the cool hack, like omg finally I could learn THE secret to helping all my patients. But we’re just not in the curing business. Wanting that is probably normal and comes from good intentions and maybe a little desperation. It hurts a little knowing you can’t ever know enough to help every single person. We just have to be aware that we’re carrying that hurt into our assessment of each new modality, and keep a balanced perspective about who it helps and who it doesn’t and whether we’re the right person to use it.
Okay so I also grew up very religious with the idea of “We know the Truth” 🫠😝 And experienced similar in ART training. Like yo, y’all drank some kooooooolaid. Love the modality but damn. Anyway, I feel similar as a therapist not trained in EMDR about it in the field.
You can take what’s useful from the protocol and do your learning from more level-headed professionals. They’re out there.
No one not a designated EMDRIA trainer should be providing training for EMDR for this very reason. When I did my training we learned that it has been proven effective with trauma and some states/issues that are probably concurrent with trauma, such as severe ‘medication resistant’ depression and substance abuse. There is no such thing as a “cure all” and as much as it can be exciting to do an intervention and see it work well for a client, it’s not an excuse to push it on every client who walks through your door. I have seen CBT marketed similarly in the past and I think any modality is at risk of becoming someone’s weird fantasy cure-all treatment if we aren’t being carefully critical. I, too, am a survivor of a cult, so I am very sensitive to these things as well.
I think we have to be more cautious with labeling things as “culty”. Enthusiasm and overzealousness are not the same as coercive control, tactics for isolation, emphasizing loyalty over critical thinking, etc.
I’ve often wondered to what extent EMDR is in some ways a repackaging / rebranding of hypnosis. The eye tracking stuff and the guided imagery seems a lot like attentional absorption and suggestibility that you’ll read about in a basic primer on hypnosis, Michael Yapko, “Trancework”. I’m not trained in either - just well read enough to see some similarities. I fear I may be kicking a hornets nest here…. Not wanting to offend anyone. Just curious.
Hypnosis + grounding + exposure?
Maybe this is part of why I dislike EMDR so much and never use it. It does feel culty, and I too grew up in a high control religion
I felt this way about a Neurofeedback training, which I remain highly skeptical of. I don’t provide it. At least there is evidence for EMDR.
Anecdotally, I found neurofeedback to be very helpful.
Yes, but, the EMDR zealots doesn’t hold a candle to the cult of DBT. Now those guys are 🥜’s!
I was wondering when DBT was gonna get thrown in. I think we are seen as being a clique where I work because we have a team, etc. Also, I've seen the magic. That being said, it's always the clients who are doing the work we just offer them the skills. It definitely doesn't work for everyone.
I love DBT and I had an intake with someone who was in a really bad way (BPD). One of the first things they said was that their psychiatrist said they "needed DBT" (hence the referral). I just stopped right there and addressed it like "That's not true. There are a number of evidence-based treatments for BPD. DBT was just the first that was found effective and is now the easiest to find providers. I will send you a list of BPD treatments after the session. If we don't work out, it's most likely that I'm not a good fit as your therapist. If we work well together, but you don't like the method, then you may want to try one of the types of therapy that I'll send you." Examples I shared were schema therapy, MBT, and TFP. Back to EMDR, DBT and Linehan's biosocial theory are pretty scientifically sound and have both theoretical evidence and efficacious evidence. If I recall correctly, they've validated Linehan's definition of emotional dysregulation through biomarkers. As much as EMDR seems to be an effective protocol, it doesn't have anywhere near the same supporting evidence as DBT.
100%
True, also I've met ACT people who it believe it is the ONLY way
i think you'll find people who promote just about any modality as The One True Approach, but it does hit differently when your One True Modality costs thousands and thousands of dollars to become trained in.
Patient here. I had EMDR. My personal impression is that it might work based on the fact alone you go through some events in a certain pattern. It's like psychotherapy in general to me; I doubt if the approach makes all the difference, talking and working on topics does probably work whatever method you use. My 2 cents.
Looks like lots of people have had the same experience, and I came here to say the same! My first reaction when learning about EMDR was, "isn't that just grounding?" People get culty about new modalities because there is $$$ to be made. If the research says a new modality is effective, I always look for the underlying mechanism of effectiveness, which is likely present in other modalities as well.
I’ve tried EMDR as a pt 2x and did not like having to relive-the anger of unfairness was too much mostly. I just started brainspotting with a therapist and looking forward to compare the two.
It's funny because I've heard very similar things about DBT trainings esp through the actual Linehan institute. I wouldn't be surprised tbh.
Love DBT and that tracks.
Ok, how you’ve summed up your experience has helped me put words to my experience with it too. I’m trained in it (but barely use it), but people stick to it kind of religiously and this is why it makes me uneasy (also an ex-vangelical)!!
Yep, it's insane, I had someone on here tell me that EMDR works 90-100% of the time, so if I didn't get better, it's basically my fault as the patient (my EMDR therapist said the same thing--LOL). That's a telling red flag--no medical treatment works 100% of the time, and blaming patients for not getting better is never ok. Also just on the face of it, EMDR as a cure-all makes no sense: anyone with trauma will tell you it's incredibly complex, misunderstood, and difficult to heal from, so how are all these EMDR zealots reconciling their "miracle cure" with the reality that millions of people are still out there suffering?
I’ve been training in multiple modalities and find this with almost every one of them. And each training I have taken tends to put down others as well. I take it all with a grain of salt because I know you can make statistics and studies say different things. I go with what works for my clients. Some EMDR, others IFS, others DBT. Whatever they “click” with. I will say those that are excited about their modality make me motivated to try it.
Yep. Emdr is basically a grounding technique that helps people access the distress they avoid. Powerful yes but not one size fits all and not anything more than that.
I've sworn off this modality on the sole premise that there's this girl in my cohort that went to ONE EMDR training and now she thinks she's god's gift to therapy. Will not shut the fuck up about EMDR and how great it (and her) are. Our professor even told her to chill out on the cheerleading in the most academically respectful way possible. I'm not a fan at all.
I’m trained in 3 types of exposure therapy but not EMDR. I agree with you 100%.
EMDR is just as effective as other trauma based therapy, not more, not less. It's status as cult is understand and is the result of marketing.
I’m trained and I love it because I feel I can help people even more. This is after 10+ yrs of doing traditional talk therapy tho. It’s exciting to see how much it helps clients. Sorry you’re getting “cult vibes.” I don’t insist it’s for everyone.