Does EMDR work better than standard behavior and cognitive-behavior therapies?

No. Most behavior and cognitive-behavior therapies for anxiety rely on a core principle of change: exposure. That is, these treatments work by exposing clients repeatedly to anxiety-provoking stimuli, either in their imagination (“imaginal exposure”) or in real life (“in vivo exposure”). When exposure to either type is sufficiently prolonged, clients’ anxiety dissipates within and across sessions, generating improvement.

When scientists have compared EMDR with imaginal exposure, they have found few or no differences. Nor have they found that EMDR works any more rapidly than imaginal exposure. Most researchers have taken these findings to mean that EMDR’s results derive from the exposure, because this treatment requires clients to visualize traumatic imagery repeatedly. Last, researchers have found scant evidence that the eye movements of EMDR are contributing anything to its effectiveness. When investigators have compared EMDR with a “fixed eye movement condition”—one in which clients keep their eyes fixed straight ahead—they have found no differences between conditions. In light of those findings, the panoply of hypotheses invoked for EMDR’s eye movements appears to be “explanations in search of a phenomenon.”

So, now to the bottom line: EMDR ameliorates symptoms of traumatic anxiety better than doing nothing and probably better than talking to a supportive listener. Yet not a shred of good evidence exists that EMDR is superior to exposure-based treatments that behavior and cognitive-behavior therapists have been administering routinely for decades. Paraphrasing British writer and critic Samuel Johnson, Harvard University psychologist Richard McNally nicely summed up the case for EMDR: “What is effective in EMDR is not new, and what is new is not effective.”

https://www.scientificamerican.com/article/emdr-taking-a-closer-look/

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