Talk:Eye movement desensitization and reprocessing/Archive 9

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"Unusually for a pseudoscience"

I notice that @Terringer and @MrOllie have been having a dispute about this line. Personally I favor removal of that line, since I think the balance of the sources very much show that EMDR as a whole is not pseudoscientific. One academic book, however reliable, doesn't override several big WP:MEDORG sources that call EMDR an evidence-based treatment for PTSD.

This is separate from whether the eye movements or Shapiro's original proposed explanation were pseudoscientific. Those may well be; at the very least the eye movements are only marginally supported by evidence at best, and Shapiro's original proposed explanation has received basically no independent support and seems to be pretty clearly debunked. While we have many sources that endorse EMDR as evidence-based, the strongest ones are mostly either agnostic as to the mechanism or explicitly endorse it as a form of exposure therapy. Loki (talk) 17:11, 4 May 2023 (UTC)

Seems well-sourced. Can't think why it should be removed. We're not going to re-run the disruptive fallacy about what-sources-don't-say again are we? Bon courage (talk) 17:13, 4 May 2023 (UTC)

We have discussed this at length multiple times. The MEDORG sources don't support the arguments you're trying to use them for. We don't need to re-litigate this again from scratch because a newbie editor made some drive-by edits without consulting the talk page. MrOllie (talk) 17:41, 4 May 2023 (UTC)

Right, the pseudoscience-in source straight-up says almost this exact phrasing. Very well supported. — Shibbolethink ^{(♔ ♕)} 17:43, 4 May 2023 (UTC)

Regardless of the sourcing, this is certainly an odd phrase in context. Up to that point, the only mention of "pseudoscience" was in the intro. 162.212.155.78 (talk) 21:33, 4 May 2023 (UTC)

I agree with Loki and Terringer that the intro "Unusually for a pseudoscience" is best removed. The pseudoscience point is clear and visible in several sections of the article, including the lede. It has not been marginalized. Yes, the phrase can be verified in the source but, as always, just because something is verifiable does not mean it is automatically WP:DUE as part of this sentence. WP:VNOT Cedar777 (talk) 21:54, 4 May 2023 (UTC)

Mostly what Cedar said. I do realize this is almost a direct quote from the source. That's why I said One academic book, however reliable, doesn't override several big WP:MEDORG sources that call EMDR an evidence-based treatment for PTSD (emphasis added). Loki (talk) 01:23, 5 May 2023 (UTC)

Adding boldface to the same argument based on irrelevant sourcing doesn't make it more convincing. MrOllie (talk) 01:54, 5 May 2023 (UTC)

The problem is an inconsistent sense of the word evidence. Nothing unusual for there to be a lot of evidence for a pseudoscientific treatment. However, this phrase is talking about randomized controlled trials, which are a very specific type of evidence, and a type that is specifically less likely to support pseudoscience. So let's not apples and oranges what the preponderance of sources support. DolyaIskrina (talk) 02:33, 5 May 2023 (UTC)

To briefly devil's advocate, that's why it's unusual. (However, y'know, WP:EXTRAORDINARY). Loki (talk) 00:50, 6 May 2023 (UTC)

I might be missing your point. Let me try to make mine better. The fact that randomized controlled trials have been done, is indeed unusual for a pseudoscience. It doesn't matter what the total number of studies is. What matters is what do the better studies show? Is there a relationship between the quality of the studies and the apparent effect? Do only the low powered crappy studies show the best results? And then there's EMDR's questionable origins and lack of a plausible mechanism. The elephant in the room is the generally sorry evidence base for most all psychotherapy. It's a low bar that EMDR is ambiguously clearing. IMO it's been approved by various organizations because it's popular and has a lot of otherwise respectable practitioners and it's not obviously harmful. You know, like Psychoanalysis, another pseudoscience. DolyaIskrina (talk) 04:01, 6 May 2023 (UTC)

My devil's advocated point is more or less the same as what you just said: the source says "unusual for a pseudoscience" because it's unusual for a pseudoscience to be supported by randomized controlled trials, seeing as randomized controlled trials are usually the gold standard for determining whether a treatment is effective.

But breaking out of devil's advocate mode, that triggers WP:EXTRAORDINARY: it's quite an extraordinary claim to say that a pseudoscience is supported by randomized controlled trials (or to put it another way, that something supported by randomized controlled trials is a pseudoscience), so we'd need more than just the one source that says it to say that.

(Also, big medical organizations don't in fact endorse psychoanalysis as treatment for anything, as far as I'm aware.) Loki (talk) 04:30, 6 May 2023 (UTC)

It's not really "supported" by RCTs, since the RCTs were all of shit quality, as we say. Loki is proposing some kind of convoluted synthesis which is unfathomable. Just reflect the high-quality source; it's not hard. Bon courage (talk) 05:54, 6 May 2023 (UTC)

The highest quality sources are the WP:MEDORG sources which are also the sources which call EMDR "evidence-based". Loki (talk) 06:36, 6 May 2023 (UTC)

Not doing this dumb argument again. WP:STICKTOSOURCE. Bon courage (talk) 06:44, 6 May 2023 (UTC)

useful more current (9/22) article

"Over the past decade, a seemingly unconventional treatment has wedged its way into mainstream therapy."

https://www.nytimes.com/2022/09/19/well/emdr-therapy.html

.

the attempted pseudoscience insertions here, based on 1 old ref, damage the article's credibility and are out of date. things have moved on. 5.66.63.86 (talk) 09:00, 6 May 2023 (UTC)

off topic
::::::::::::Steaming your vagina is even more popular.[1] Doesn't make it a good idea. Bon courage (talk) 09:07, 6 May 2023 (UTC)

The topic of this thread is the sentence intro "Unusually for a pseudoscience" when reflecting that sources support the fact that the subject has been subject to RCTs. There is no dispute that the subject, EMDR, has in fact been subject to RCTs. That part of the sentence is universally agreed upon and is DUE. It's the intro that several editors have issues with. The intro is contested and there is no consensus that it be included. WP:ONUS

Again, pseudoscience is clearly discussed in multiple locations in the article. It does not need to be included yet again in this sentence. Cedar777 (talk) 09:55, 6 May 2023 (UTC)

It does. Can’t cherrypick one factoid out of an observation. Bon courage (talk) 09:57, 6 May 2023 (UTC)

Collins dictionary defines pseudoscience as "a discipline or approach that pretends to be or has a close resemblance to science."

EMDR practitioners do not claim a science for EMDR. Thus it is not a pseudoscience.

It is just something that empirically works for some people (and thus is recommended by WHO, NICE etc).

works for some people. 5.66.63.86 (talk) 10:56, 6 May 2023 (UTC)

EMDR practitioners absolutely claim it's science, but that also is not our bar for what counts. We go with what the sources say. — Shibbolethink ^{(♔ ♕)} 15:43, 6 May 2023 (UTC)

IP 5.66.63.86, I'm afraid you are simply mistaken. Francine Shapiro, the founder, did publish her research in 1989 in the Journal of Traumatic Stress and present it as science. A number of people took issue with it, in particular Richard McNally. McNally was a vocal critic of EMDR for many years but he did revise his assessment after 2017 or so. A number of RCTs have been conducted and they have continued into the 2020s. According to the US Veterans Administration: "Since the early 1990s, there have been over 20 total randomized controlled trials (RCTs) of EMDR with adults, with more in progress."[2] The best quality WP:MEDRS sources don't have universal agreement about EMDR. The language and source we are discussing in this thread is from 2015. There have been additional RCTs that have taken place since then. We need to be carful with WP:DUEWEIGHT. Cedar777 (talk) 22:17, 6 May 2023 (UTC)

WP:EXTRAORDINARY as an argument doesn't do much here, given that the source we're using is actually extremely high on the quality ladder.

It is an expert-authored (Lilienfeld, Lynn, Gambrill, Herbert, Gaudiano, Lohr, Mann, Rosen, Gist, Barden, Tavris, McNally, Mercer, Loftus), expert-edited (Thyer and Pignotti), topic-relevant (has more than a dozen pages dedicated to EMDR) academic review monograph published by a very high impact publishing house (Springer). It doesn't get much better than that.

Then we also have sources like these to help back it up: [3][4][5][6] Each of these emphasizes that EMDR, while not an obvious pseudoscience at first glance, still meets many of its criteria, despite the many studies conducted on it, due to the poor design of such studies. That's what we say here, ergo: easily satisfies ECREE. — Shibbolethink ^{(♔ ♕)} 15:48, 6 May 2023 (UTC)

Sorry to extend this tangent, I won't comment beyond this, but the evidence for Psychoanalysis looks very similar to EMDR and in 2010 the APA called psychoanalysis "empirically validated" DolyaIskrina (talk) 17:12, 6 May 2023 (UTC)

Sources

also off topic
ridiculous. I'm sure somebody somewhere, to use an example above, thinks thinks that "Steaming your vagina" has a science basis. That does not mean that is the consensus view. 5.66.63.86 (talk) 17:19, 6 May 2023 (UTC)

Commenting here to say that earlier today I edited the opening of that sentence out (admittedly without looking at the talk page first, as it seemed pretty unambiguously mistaken to me at the time), though my edit has since been reverted. The reason why I did so is not because of the arguments mentioned here so far, but because the claim that most pseudosciences haven't had RCTs (which is the context of the phrase being debated) is very questionable, verging on false. As mentioned in my edit notes, well-known pseudoscientific fields (such as parapsychology, homeopathy, and even dowsing!) have been subject to many RCTs! These randomized controlled studies usually find the pseudoscience not to be effective, of course, but that does not alter the fact that it is simply not that unusual for scientists to conduct RCTs on a pseudoscientific field. This should be obvious; after all, a field is usually only established as pseudoscientific after scientists have looked into it and discarded the relevant hypotheses!

In my opinion, we should state that RCTs have been conducted, because that is both true, citable, and (probably) notable, but we should not claim that the mere fact that this is the case is "unusual for a pseudoscience". This is all outside of the ongoing debate as to whether the subject is actually pseudoscientific or not; my objection to the statement (as it stands) holds regardless of how that debate plays out.

Yitz (talk) 03:15, 8 May 2023 (UTC)

I went to the source assuming that it said something like "positive RCTs", but y'know, you're right. It just says What sets EMDR apart from most approaches considered to be pseudoscientific is that a number of RCTs have been conducted on EMDR, leading it to be listed as an empirically supported treatment for PTSD by the Division 12 of the American Psychological Association, because it meets that group’s criteria of having at least two randomized controlled studies with positive results. Nevertheless...

It definitely implies that it means positive RCTs, but it doesn't say that. Loki (talk) 03:59, 8 May 2023 (UTC)

Unless anyone has any further objections, I'm going to go ahead and revert the reversion on my prior edit. If that's not okay for any reason, please let me know. I'm also going to do some more research on this subject in general, as I'm getting the sense (from both the edit history and talk page) that the way the article is currently written may not reflect the general consensus. Additionally, I mentioned this article to a liscensed therapisty yesterday, who claimed that the page is quite outdated and that the mainstream consensus in her field is currently leaning in favor of EMDR. Are there any "must-read" threads in the talk page archives (or elsewhere) I should peruse before editing further? Yitz (talk) 21:23, 8 May 2023 (UTC)

@Yitzilitt The "general consensus" according to wikipedia's WP:MEDSCI is determined by secondary peer-reviewed journal articles published in expert-edited topic-relevant journals, and similar peer-reviewed books and monographs, not a single random therapist. Those articles state EMDR is helpful as a tool, but that it's "special sauce" e.g. eye movements are likely not independently efficacious when compared to similar therapies without such movements. AKA it is a purple hat therapy.

If you want to make broad changes to the article, you should start an RFC, not just state you're going to start making changes. The "untestable hypothesis" is the claim put forward by multiple EMDR practitioners that the mechanism is different in several different studies, moving the goalposts, refusal to use proper control groups because of these "special mechanisms". E.g. that the eye movements in EMDR create a "special state" in which memories are rewritten. This is not testable with current technology. [7] — Shibbolethink ^{(♔ ♕)} 21:28, 8 May 2023 (UTC)

@Shibbolethink I am aware of how WP:MEDSCI works. Apologies if my wording was confusing; what I meant was simply that this encounter served as anecdotal evidence for my suspicion that something may be amiss here, and made me think that I should do more research. I mentioned it because in the past I've found that sharing some details of my thought process in the talk page has been helpful to others. (for example, getting people in touch with domain experts who may have more resources than me, or retracing how someone found a particular source, etc.). Yitz (talk) 21:36, 8 May 2023 (UTC)

Re Are there any "must-read" threads in the talk page archives (or elsewhere) Have a look at Wikipedia:Fringe_theories/Noticeboard/Archive_92#EMDR MrOllie (talk) 21:43, 8 May 2023 (UTC)

@Shibbolethink So just to be clear, the following three claims are all distinct:

A) While EMDR is an effective treatment, the effectiveness is due primarily to the exposure-like parts and not the eye-movement parts.

B) EMDR is a purple hat therapy, i.e. it's an ineffective treatment added to a treatment already known to be effective to create the impression of a new effective treatment.

C) EMDR is pseudoscientific, i.e. it's a clearly bogus or unfalsifiable treatment that claims to be a scientific evidence-based treatment.

Why are A and B distinct? Because being a treatment with exposure-like parts is not the same as being exposure + eye movements: it's possible that the exposure parts of EMDR and the exposure parts of CBT have clinically relevant differences despite operating on the same principle, and the sources appear to differ on this point. We do know there are some differences (for instance, traditional CBT focuses more on IRL exposure while EMDR focuses more on imaginal exposure) but it's not really clear what the clinical relevance of these differences are.

I'm making this point because we see a lot of A in the sources from highly respected sources even now. But the amount of B and C decreases the more modern the source gets, and conversely the more modern sources contain more explicit contradictions of C and sometimes even B. Loki (talk) 15:40, 11 May 2023 (UTC)

Once knowledge is settled it doesn't need renewing. Your assertion about "explicit contradictions" is false (if you mean in RS, otherwise why raise it?). Bon courage (talk) 15:55, 11 May 2023 (UTC)

it's possible that the exposure parts of EMDR and the exposure parts of CBT have clinically relevant differences despite operating on the same principle, and the sources appear to differ on this point
I know of no reliable non-EMDR sources which assert this. Literally none. Do you have quotes? Classical exposure therapy does not focus "more on IRL exposure", it includes exposure through thought and visualization. CBT is not exposure therapy. E.g. [8] Exposure therapy is often used in tandem with CBT but they are distinct. A and B are roughly equivalent, B is a further explanation of A. C often follows from A and B, and is described as following from A and B in our most reliable sources. None of this is a good reason to get rid of well-sourced content. — Shibbolethink ^{(♔ ♕)} 16:34, 13 May 2023 (UTC)

The example that comes to my head immediately is that a bunch of the meta-analyses say that EMDR is often more accepted by patients (i.e. has a lower dropout rate) than traditional CBT.

But furthermore, many sources treat A and B as clearly distinct. So for instance the Australian medical authority calls EMDR highly evidence-based, and also says that it's very similar to exposure. So does Bessel van der Kolk, who outright calls EMDR a form of exposure therapy, and also endorses it highly. Neither of these sources call EMDR a purple hat therapy, and while this is admittedly conjecture, I think it's very clear that neither of these sources would call EMDR a purple hat therapy.

And that that's not because they think the eye movements are particularly effective, because it's reasonably clear that they don't. Both of them endorse EMDR as a form of exposure therapy. Loki (talk) 17:37, 13 May 2023 (UTC)

None of those sources actually address the concept of EMDR as incorporating evidence-based practices and then adding non-evidence based ones on top of it, as in a purple hat therapy. To say in article text that they support that EMDR is not a purple hat therapy, or to use those to remove the purple hat therapy content, would be WP:SYNTH, as they do not actually address that claim. That appears to be your interpretation. — Shibbolethink ^{(♔ ♕)} 17:49, 13 May 2023 (UTC)

Shibbolethink is right (as usual). As Samuel L Jackson once said, 'The absence of evidence is not evidence of absence'. When a source is silent on an issue that cannot be taken to mean they agree with your position. MrOllie (talk) 17:57, 13 May 2023 (UTC)

I strongly agree with removing this. Unambiguously calling EMDR "a pseudoscience" is a strong and controversial position on what is clearly a subject of much current debate in the scientific community, and therefore a violation of WP:NPOV. From WP:FRINGE/QS: "Articles about hypotheses that have a substantial following but which critics describe as pseudoscience, may note those critics' views; however, such hypotheses should not be described as unambiguously pseudoscientific if a reasonable amount of academic debate still exists." Nowhere else in the article is the pseudoscience claim stated without qualification. Even the cited source does not call EMDR a pseudoscience, but rather an "approach... considered to be pseudoscientific." Paraphrasing that to an unambiguous claim that EMDR is a pseudoscience is absolutely unverified and non-neutral. GreatBigCircles (talk) 18:24, 29 May 2023 (UTC)

There is no debate about pseudoscience. Follow the sources. Bon courage (talk) 19:08, 29 May 2023 (UTC)

I am following the sources:

There’s some controversy surrounding why EMDR works. The creator of EMDR, Dr. Francine Shapiro, later developed a working theory about how your brain stores memories after accidentally discovering the eye movement technique she later used to create this therapy technique. However, that controversy doesn’t extend to whether or not EMDR does work. Dozens of controlled trials and research studies have analyzed EMDR and shown that it’s effective.
— "EMDR Therapy: What It Is, Procedure & Effectiveness". Cleveland Clinic.

Today, clinicians generally consider E.M.D.R. an effective treatment for trauma.... But scientists are debating whether E.M.D.R. is more effective than other trauma treatment methods.
— Blum, Dani; Park, Sophie (2022-09-19). "'One Foot in the Present, One Foot in the Past:' Understanding E.M.D.R." The New York Times. ISSN 0362-4331.

Eye-movement Desensitization and Reprocessing (EMDR) has been widely supported in the literature for its effectiveness in treating Post-traumatic Stress Disorder (PTSD) and a variety of other diagnoses and symptoms. The variable findings regarding whether its effects are for reasons unique to this treatment, however, have become the focus of extensive discussion and debate.
— Sikes, Charlotte & Sikes, Victoria. (2003). EMDR: Why the controversy?. Traumatology. 9. 169-182. 10.1528/trau.9.3.169.22270.

EMDR appears to be a safe therapy, with no negative side effects. Still, despite its increasing use, mental health practitioners debate EMDR's effectiveness. Critics note that most EMDR studies have involved only small numbers of participants. Other researchers, though, have shown the treatment's effectiveness in published reports that consolidated data from several studies.
— "EMDR: Eye Movement Desensitization and Reprocessing". WebMD.

GreatBigCircles (talk) 17:26, 30 May 2023 (UTC)

And? None of this is about pseudoscience. It's effective because of the basis it co-opts. Doesn't stop it being a pseudoscience. This has been discussed ad nauseam now at multiple noticeboards. Bon courage (talk) 17:35, 30 May 2023 (UTC)

this article is a disaster for wikipedia.

2 people insist on inserting "Unusually for a pseudoscience, " out of context into a section on effectiveness. 5.66.63.86 (talk) 18:47, 30 May 2023 (UTC)

The context is that it directly follows the wording of the source. It would be misrepresenting the source to include only half the sentence. MrOllie (talk) 20:01, 30 May 2023 (UTC)

As I pointed out in my original comment, it is the phrase in question that is misrepresenting the source: Even the cited source does not call EMDR a pseudoscience, but rather an "approach... considered to be pseudoscientific." GreatBigCircles (talk) 20:33, 30 May 2023 (UTC)

It is in a chapter titled Pseudoscience in Treating Adults Who Experienced Trauma. A couple quotes: Another way in which EMDR qualifies as a pseudoscience... ... EMDR has been said to use social influence strategies that are consistent with those used by other forms of pseudoscience MrOllie (talk) 20:40, 30 May 2023 (UTC)

Very well, thank you for the additional quotes; I concede that the original source is not misrepresented. However, as has been pointed out above, one source against a mountain of scientific evidence does not warrant such a biased treatment in this article. GreatBigCircles (talk) 21:11, 30 May 2023 (UTC)

There isn't a 'mountain of scientific evidence'. Please read prior discussion thoroughly. There is a 'mountain of scientific evidence' that exposure therapy works. That does not equate to evidence that EMDR's additions make it any better than other forms of exposure therapy. MrOllie (talk) 21:16, 30 May 2023 (UTC)

There is clearly no consensus here (nor in the scientific community). The disputed claim should be removed until a consensus is reached.

I'm genuinely confused and curious about why a couple of active editors seem to be so attached to ensuring that alternative viewpoints don't get represented in this article. What is it you're worried about? That someone will consider EMDR a serious treatment, as countless professionals do? That they'll be hoodwinked by some charlatan who takes their money and... administers a treatment that is well established as safe and just as effective as any other treatment, but based on some non-scientific theories? From the outside, it really looks like you're being reactionary, unilaterally blocking other people's good faith efforts to improve the neutrality of this article in order to avoid lending any credibility to something you see as contemptible. I don't want to assume that, though, which is why I would love to know what value you're actually trying to protect. I imagine it's one we share.

EDIT: In the struck text above, I was attempting to find shared values as a first step toward compromise, but I got some feedback that it might have been interpreted as a personal attack. I can see how it might have come across that way, and I apologize. I'm leaving it struck out because I'm not sure of the correct protocol for editing a message that's been responded to. GreatBigCircles (talk) 22:06, 30 May 2023 (UTC)

@GreatBigCircles: I quote here from WP:PA: "Comment on content, not on the contributor(s)." JoJo Anthrax (talk) 22:18, 30 May 2023 (UTC)

The sources say it (probably) works; the sources say it's pseudoscience. Wikipedia reflects those sources. Job done. GreatBigCircles seems to think that one lot of sources "cancel out" others. This is both WP:OR and fallacious reasoning (relatedly, see Purple hat therapy), which manifests as WP:PROFRINGE. The PAs on top do not help - this topic has already been aired an WP:ANI (where incidentally, it was said our article is being too coy about the pseudoscience). Bon courage (talk) 03:36, 31 May 2023 (UTC)

It seems you've misunderstood my intention; I apologize if I wasn't clear. I have no interest in favoring one set of sources over another. In fact, I believe that is exactly what the current wording is doing. Some reliable sources say pseudoscience, other reliable sources say science. Therefore, it is inappropriate to represent the view of only one set of sources as if that view were an undisputed fact. Both viewpoints need to be represented fairly and attributed to their respective sources. Again, From WP:FRINGE/QS: "Articles about hypotheses that have a substantial following but which critics describe as pseudoscience, may note those critics' views; however, such hypotheses should not be described as unambiguously pseudoscientific if a reasonable amount of academic debate still exists." GreatBigCircles (talk) 16:30, 31 May 2023 (UTC)

There is no debate over whether it's pseudoscience: it is. There's little debate over efficacy: it probably works. We say these things. Bon courage (talk) 16:39, 31 May 2023 (UTC)

other reliable sources say science Be specific. Which sources? When we get into specifics those sources never seem to hold up - they're either unreliable or they are talking about something else. Also have a look at WP:FALSEBALANCE. We don't really do fox-style fair and balanced here. MrOllie (talk) 17:10, 31 May 2023 (UTC)

I have named and quoted several reliable sources multiple times. GreatBigCircles (talk) 21:59, 31 May 2023 (UTC)

No, you've named and quoted sources that are unreliable, about effectiveness rather than science/pseudoscience, or both at the same time. MrOllie (talk) 22:36, 31 May 2023 (UTC)

I would like to salute @MrOllie for the first actually constructive edit I've seen in this debate: removing the whole sentence. 9 days later, that edit has not been challenged, and I think it's a great solution. Thank you! Shall we consider this topic resolved? GreatBigCircles (talk) 19:32, 10 June 2023 (UTC)

Good enough compromise for me. — Shibbolethink ^{(♔ ♕)} 19:34, 10 June 2023 (UTC)

P.S. To be clear, I'm referring to the debate over the phrase "Unusually for a pseudoscience" specifically. The NPOV dispute stands. GreatBigCircles (talk) 19:35, 10 June 2023 (UTC)

What else about that dispute stands? — Shibbolethink ^{(♔ ♕)} 19:41, 10 June 2023 (UTC)

NPOV dispute: pseudoscience and evidence

Unambiguously presenting EMDR as a pseudoscience without acknowledging the scientific support for it is a strong and controversial position on a subject of much current debate in the scientific community, and therefore a violation of WP:NPOV. From WP:FRINGE/QS: Articles about hypotheses that have a substantial following but which critics describe as pseudoscience, may note those critics' views; however, such hypotheses should not be described as unambiguously pseudoscientific if a reasonable amount of academic debate still exists.

I have been attempting to add well-sourced factual information to this article about the abundant evidence that EMDR is safe and effective, without removing any of the statements about it being called a pseudoscience. I am attempting to add a little bit of balance to an article that is very heavily slanted toward a particular, controversial view. My edits have been cited with multiple reliable sources. However, they have been summarily and repeatedly reverted. Therefore, I have added the POV tag to the article. It should remain until the article presents a more balanced perspective and draws more attention to the scientific evidence supporting this practice.

Here are a few of the reliable sources discussing the EMDR controversy:

There’s some controversy surrounding why EMDR works. The creator of EMDR, Dr. Francine Shapiro, later developed a working theory about how your brain stores memories after accidentally discovering the eye movement technique she later used to create this therapy technique. However, that controversy doesn’t extend to whether or not EMDR does work. Dozens of controlled trials and research studies have analyzed EMDR and shown that it’s effective.
— "EMDR Therapy: What It Is, Procedure & Effectiveness". Cleveland Clinic.

Today, clinicians generally consider E.M.D.R. an effective treatment for trauma.... But scientists are debating whether E.M.D.R. is more effective than other trauma treatment methods.
— Blum, Dani; Park, Sophie (2022-09-19). "'One Foot in the Present, One Foot in the Past:' Understanding E.M.D.R." The New York Times. ISSN 0362-4331.

Eye-movement Desensitization and Reprocessing (EMDR) has been widely supported in the literature for its effectiveness in treating Post-traumatic Stress Disorder (PTSD) and a variety of other diagnoses and symptoms. The variable findings regarding whether its effects are for reasons unique to this treatment, however, have become the focus of extensive discussion and debate.
— Sikes, Charlotte & Sikes, Victoria. (2003). EMDR: Why the controversy?. Traumatology. 9. 169-182. 10.1528/trau.9.3.169.22270.

EMDR appears to be a safe therapy, with no negative side effects. Still, despite its increasing use, mental health practitioners debate EMDR's effectiveness. Critics note that most EMDR studies have involved only small numbers of participants. Other researchers, though, have shown the treatment's effectiveness in published reports that consolidated data from several studies.
— "EMDR: Eye Movement Desensitization and Reprocessing". WebMD.

Again, I am not interested in removing any of the criticisms of EMDR from the article, only in improving the neutrality by acknowledging that EMDR is a subject of valid academic disagreement.

More information is available in the "Unusually for a pseudoscience" section above. GreatBigCircles (talk) 22:37, 30 May 2023 (UTC)

is there a wiki process whereby this long-running and important argument can be referred upwards to a star chamber of senior editors for adjudication? 5.66.63.86 (talk) 03:20, 31 May 2023 (UTC)

You could raise it (again) at WP:FT/N to get lots more attention. Bon courage (talk) 03:26, 31 May 2023 (UTC)

WebMD and Cleveland clinic are not reliable for anything much. And why raise lay sources when there are peer-reviewed journal articles and academic textbooks available? Bon courage (talk) 03:39, 31 May 2023 (UTC)

One of the issues here is that EMDR organisations get tempted into putting forward a science theory for EMDR. e.g. https://emdr-europe.org/ mention of "unprocessed memories".

It would be better if the EMDR organisations instead just said "The scientific explanation for the effectiveness of EMDR is not known."

Then everyone could focus on the empirical fact that many people find EMDR very valuable in resolving trauma. 5.66.63.86 (talk) 04:09, 31 May 2023 (UTC)

No, everyone should just "focus on the fact" of what reliable sources say, because reflecting that knowledge is the sole purpose of being here. Bon courage (talk) 04:11, 31 May 2023 (UTC)

It was said earlier that "EMDR is a subject of valid academic disagreement". If there are sources stating this, shouldn't it be presented in the article as such? DN (talk) 18:10, 31 May 2023 (UTC)

The bigger issue is that OP wishes to remove the content describing EMDR as a purple hat pseudoscience, based on sources which say there is academic disagreement. one does not "cancel out" the other. And Wikipedia doesn't decide which disagreements are "valid" and which are not. — Shibbolethink ^{(♔ ♕)} 22:04, 31 May 2023 (UTC)

I'm sorry, but you are mistaken. As I have said repeatedly, I do not wish to remove any of the criticism of EMDR from the article. I have not attempted to remove anything at all from the article except for the extremely biased and controversial phrase "Unusually for a pseudoscience." I only want to add text. Here is the exact text I have been blocked from adding: There is substantial evidence that EMDR is a safe and effective treatment for PTSD and a number of other psychological conditions. However, there is much debate about how it works and whether it is more effective than other treatments. GreatBigCircles (talk) 23:33, 31 May 2023 (UTC)

FWIW, I echo your criticism of the article and totally support adding this text, with one caveat:

I don't think there's actually much debate over whether EMDR is more effective than other treatments (there's not a lot of evidence that it is, at least relative to the most effective alternate treatment). Nor is there really much debate on whether it's equally effective (it is). I've seen some studies say it does better on acceptability than other therapies, but the real criticism here is a relatively subtle point about whether its mechanism of action is unique or if it's exposure therapy in a funny hat (and how much that matters if it's true). Loki (talk) 02:34, 1 June 2023 (UTC)

So as long as what is added isn't contradictory, I think it's worth a try ie WP:BRD...DN (talk) 03:06, 1 June 2023 (UTC)

It was contradictory, using crap sourcing to make EMDR look more effective that our RS cited in the article say it is. Bon courage (talk) 05:03, 1 June 2023 (UTC)

It's a WP:LEDEBOMB with some very poor sourcing, including out-of-date stuff, stuff by Shapiro herself, and a fake journal. This is starting to get disruptive. There are some basic things here going wrong: using crap sources and adding stuff straight to the lede is bad, and for a WP:CTOP very bad. Bon courage (talk) 05:00, 1 June 2023 (UTC)

If you think it's so bad, then stop reverting and MAKE IT BETTER. WP:ROWN.

WP:LEDEBOMB is your personal opinion, not an official policy. GreatBigCircles (talk) 05:34, 1 June 2023 (UTC)

The essay links to the relevant PAGs. if you don't know that ledes must summarize bodies and are edit warring to the contrary it seems we have a WP:CIR issue. Edit-warring a predatory journal back in is so incompetent it almost looks like deliberate trolling. Bon courage (talk) 05:52, 1 June 2023 (UTC)

I provided EIGHT reliable sources including The New York Times and FIVE peer-reviewed journals. If you are going to call those "junk sources," you need to provide some evidence of that claim. GreatBigCircles (talk) 05:46, 1 June 2023 (UTC)

See WP:MEDRS. The onus is for you to get consensus, and I can tell you now you're not going to get consensus to use predatory sources and out-of-date sources to make startling health claims, even more particularly as novel stuff crammed into a lede. Bon courage (talk) 05:54, 1 June 2023 (UTC)

@Bon courage, I am trying really hard to find compromise here. All you're doing is reverting my hard work and posting inflammatory personal attacks. I would love it if you would propose some text that you think might meet both our needs. GreatBigCircles (talk) 06:17, 1 June 2023 (UTC)

Are there any high-quality WP:MEDRS or other quality scholarly sources we're not using? I am interested in basing content on the WP:BESTSOURCES, not pre-deciding content and then scraping around for any old source (no matter how poor) to try and prop it up. Bon courage (talk) 06:23, 1 June 2023 (UTC)

Great, we're in agreement there. Let's start from the WP:BESTSOURCES. How about The New York Times? I would love it if you would simply read that NYT article. Here, I'll use one of my 10 monthly gift links in case you don't have a subscription. Then reread the introduction here, and tell me whether you think it treats the conflicting viewpoints with more or less neutrality than the Times does. GreatBigCircles (talk) 06:44, 1 June 2023 (UTC)

I have access to the NYT and have read that article already. The NYT is a lay source and so not reliable for biomedical content (in fact newspapers are some of the very worst sources for health coneent), especially when we have peer-reviewed scholarship to hand. It may be useful for some of the society and culture aspects. Bon courage (talk) 06:52, 1 June 2023 (UTC)

Great, would you please answer the question then? GreatBigCircles (talk) 06:58, 1 June 2023 (UTC)

What question? Bon courage (talk) 07:02, 1 June 2023 (UTC)

"Then reread the introduction here, and tell me whether you think it treats the conflicting viewpoints with more or less neutrality than the Times does." GreatBigCircles (talk) 07:06, 1 June 2023 (UTC)

The NYT does not conform to Wikipedia's NPOV policy, and it shows. Typically from a news piece by a reporter (focussed on "news & trends") it does the some-scientists-say-X-some-scientists-say-Y-WOW! thing, to get a kind of WP:FALSEBALANCE. Wikipedia aspires to be rather different to, and much better than, that. An encyclopedia is not a newspaper. Bon courage (talk) 07:12, 1 June 2023 (UTC)

Okay, so you don't think the NYT can be trusted to report on science. Fine. How about this systematic review and this peer-reviewed journal article, both of which are already cited elsewhere in the article (as, btw, is the NYT)? Do you think those are "junk sources"? GreatBigCircles (talk) 07:44, 1 June 2023 (UTC)

Cochrane is nearly always apt to use, and we do use it, while also registering its caveat "Caution was urged interpreting the results due to low numbers in included studies, risk of researcher bias, high drop-out rates, and overall 'very low' quality of evidence for the comparisons with other psychotherapies", which is a bit different from what you were trying to make Wikipedia say, in an unqualified way, about "substantial evidence" for EMDR for all MH conditions. Bon courage (talk) 07:48, 1 June 2023 (UTC)

There's not a lot of high quality sources we're not using at all, but like I keep saying, we do give way too little weight to the huge pile of highly reliable WP:MEDORG sources we have. It's pretty clearly the consensus among those sources that EMDR is effective and recommended by professionals, at least for PTSD specifically. Loki (talk) 14:46, 1 June 2023 (UTC)

There's a whole section on medical guidelines (which have mixed stances). There's the effectiveness questions (which they address), and the pseudoscience question (it is one). For NPOV we have a special duty to make sure pseudosciences are identified as such. Bon courage (talk) 15:42, 1 June 2023 (UTC)

If the article already identifies it as ps I'm not sure why it would need to be reiterated over and over. As long as it is already clear that "The scientific explanation/consensus for the effectiveness of EMDR is not known" and that "EMDR is a subject of valid academic disagreement", I think that covers most of the bases. You can call the additions "Research that shows efficacy" or some such agreed upon sub-title. DN (talk) 15:57, 1 June 2023 (UTC)

Aside from the removed "unusually for a pseudoscience", where do we refer to EMDR as a pseudoscience in wiki-voice? As far as I am aware, we do not. — Shibbolethink ^{(♔ ♕)} 19:41, 10 June 2023 (UTC)

I wasn't claiming/suggesting we put it in Wikivoice, just that it is identified as such, especially here...DN (talk) 20:55, 13 June 2023 (UTC)

It has been characterized by some experts as pseudoscience. That's DUE content. — Shibbolethink ^{(♔ ♕)} 21:02, 13 June 2023 (UTC)

If we mean "characterized by some experts as pseudoscience" then we should say it like that. Loki (talk) 21:16, 13 June 2023 (UTC)

Sounds like a POV way of diminishing the input of those experts. — Shibbolethink ^{(♔ ♕)} 21:25, 13 June 2023 (UTC)

What? I'm just pointing out that the article says "characterized as pseudoscience", but you're saying it's "characterized by some experts as pseudoscience". If we mean the second thing, we should say the second thing. They really are different things. Loki (talk) 23:12, 13 June 2023 (UTC)

WP:WEASEL applies to articles, but not to Talk pages. Shibbolethink can say "some experts" here, but it does not belong in the article. --Hob Gadling (talk) 07:43, 15 June 2023 (UTC)

I didn't say it wasn't DUE. Where is that coming from, was it something I said? I don't have a stake in this article either way, I just think it's an interesting subject. I'm not here to WP:BATTLE...DN (talk) 22:36, 13 June 2023 (UTC)

PTSD vs Acute Stress Disorder

Regarding this change by @Shibbolethink:

The World Health Organization's 2013 report on stress-related conditions found "insufficient evidence" to support EMDR for acute symptoms, but recommended it with moderate evidence for adults and low evidence for children in treating chronic symptoms.

The title of the parent section is "Post-traumatic stress disorder." Acute Stress Disorder is a different condition. Why, when talking about the medical guidelines for PTSD, would we mention the lack of evidence for a different condition? I don't see why it's important to say this at all, but if you think it is, it belongs in the "Other conditions" section. GreatBigCircles (talk) 21:37, 14 June 2023 (UTC)

Agreed, I thought that sentence seemed out of order. There are of course no acute symptoms of a chronic after-the-fact diagnosis. Draken Bowser (talk) 22:02, 14 June 2023 (UTC)

The report doesn't categorize it separately, so neither can we. In fact, to quote the report: the questions did not focus on the acute stress disorder concept (which is not in the ICD), as this concept has poor predictive validity MrOllie (talk) 22:36, 14 June 2023 (UTC)

What do you mean? The report has separate sections for acute stress disorder and PTSD. We can't include conclusions concerning the effectiveness of EMDR for treating ASD under a heading discussing the use of EMDR in PTSD. Draken Bowser (talk) 22:50, 14 June 2023 (UTC)

Are you sure you're reading the WHO report being discussed here? I cannot find any section on acute stress disorder. MrOllie (talk) 22:58, 14 June 2023 (UTC)

We are talking about the 2013 report named Guidelines for the Management of Conditions Specifically Related to Stress, right? This is the report attached to sentence where the edit war was just fought. The pages we cite (8–9) concern only PTSD, conclusions concerning acute stress disorder are on page 5. The conditions are discussed separately in the report under Annex 5, for acute stress disorder sub-sections 1 through 4 and for PTSD subsections 14 through 17. Draken Bowser (talk) 06:38, 15 June 2023 (UTC)

Page 5 mentions 'Acute traumatic stress symptoms', (not Acute Stress Disorder). Again, the WHO follows the ICD (not the DSM), so trying to map these things onto DSM categories is unhelpful WP:OR. MrOllie (talk) 10:59, 15 June 2023 (UTC)

We should not make conclusions not present in the report (such as calling acute symptoms of PTSD acute stress disorder). To do so would be original research. — Shibbolethink ^{(♔ ♕)} 12:51, 15 June 2023 (UTC)

I agree, we should not call "Acute traumatic stress symptoms" Acute Stress Disorder. By the same reasoning, we should not call it PTSD, which is exactly what the current wording does. The report does not say "acute symptoms of PTSD"—there is no such thing. PTSD is a chronic condition. From Post-traumatic stress disorder: While it is common to have symptoms after any traumatic event, these must persist to a sufficient degree (i.e., causing dysfunction in life or clinical levels of distress) for longer than one month after the trauma to be classified as PTSD (clinically significant dysfunction or distress for less than one month after the trauma may be acute stress disorder). GreatBigCircles (talk) 15:18, 15 June 2023 (UTC)

we should not call "Acute traumatic stress symptoms" Acute Stress Disorder. By the same reasoning, we should not call it PTSD, which is exactly what the current wording does

Our wording actually just mirrors exactly what the source says: "acute traumatic stress symptoms". We don't call it PTSD either. — Shibbolethink ^{(♔ ♕)} 15:28, 15 June 2023 (UTC)

It is under the heading "Post-traumatic stress disorder." GreatBigCircles (talk) 15:29, 15 June 2023 (UTC)

Okay. Would changing that section heading to "Acute stress disorder and post-traumatic stress disorder" alleviate your concerns? We don't currently have any section for acute symptoms of traumatic stress, so this is the closest. — Shibbolethink ^{(♔ ♕)} 15:29, 15 June 2023 (UTC)

As I said in my original post, information about effectiveness for other conditions belongs in the "Other conditions" section. PTSD deserves its own section because that is the main thing EMDR is used for. If you think there should also be a section for ASD, that's fine with me. GreatBigCircles (talk) 15:32, 15 June 2023 (UTC)

nope. We group trauma and PTSD together elsewhere in the article, we shouldn't do differently here. That "other conditions" includes conditions entirely outside of trauma-related illness (depression, DID, etc). It would run afoul of WP:ASTONISH to put acute stress disorder in that section. Having a separate acute stress disorder section which is just that one piece of content would also run afoul of the manual of style's principles on section length. — Shibbolethink ^{(♔ ♕)} 15:33, 15 June 2023 (UTC)

Your wording is misrepresenting the source and does not make sense. The source says EMDR is effective for PTSD, not for "chronic symptoms." There is no such thing as "acute symptoms" of PTSD. Nor is there anything called "chronic symptoms" of PTSD—that's just called PTSD. GreatBigCircles (talk) 15:39, 15 June 2023 (UTC)

Your wording

Not my wording, it's the STATUSQUO contributed by multiple editors.

misrepresenting the source and does not make sense. The source says EMDR is effective for PTSD, not for "chronic symptoms." There is no such thing as "acute symptoms" of PTSD. Nor is there anything called "chronic symptoms" of PTSD—that's just called PTSD

We don't say "chronic symptoms of PTSD". We also don't say "acute symptoms of PTSD". Because you're right, all chronic symptoms of traumatic stress disorders can be grouped into PTSD. All acute (and subacute) symptoms can be grouped into acute stress disorder.

But this seems pretty easily solved by saying what the source exactly says and changing
The World Health Organization's 2013 report on stress-related conditions found "insufficient evidence" to support EMDR for acute symptoms, but recommended it with moderate evidence for adults and low evidence for children in treating chronic symptoms.

to:

The World Health Organization's 2013 report on stress-related conditions found "insufficient evidence" to support EMDR for acute symptoms of traumatic stress, but recommended it with moderate evidence for adults and low evidence for children in treating PTSD. — Shibbolethink ^{(♔ ♕)} 15:42, 15 June 2023 (UTC)

Thank you for finally offering a constructive compromise. This solves half the problem. If you are willing to reverse the order of the phrases, so that PTSD goes first—this is, again, the section on PTSD—and replace "acute symptoms" with "acute traumatic stress symptoms," as the source calls it, I am willing to leave them both. Separate sentences would be better. GreatBigCircles (talk) 15:49, 15 June 2023 (UTC)

Nah, We should order it based on how the source orders it, and then make the section heading reflect the content, not the other way around. Wikipedia headings are not based on reliable sources, whereas content is. We make headings which reflect the content in a natural way, we don't just create headings out of thin air and then keep them exactly the same forever. — Shibbolethink ^{(♔ ♕)} 15:50, 15 June 2023 (UTC)

I support Shibbolethink's proposal. The order makes sense, no rearrangements necessary. I don't have a problem with the heading if we go with this proposal, but I won't object to changing it either. Thanks. Draken Bowser (talk) 18:21, 15 June 2023 (UTC)

I like this with one amendment: change the "but" to an "and...". (Or just split the clauses: The World Health Organization's 2013 report on stress-related conditions found "insufficient evidence" to support EMDR for acute symptoms of traumatic stress. It recommended EMDR with moderate evidence for adults and low evidence for children in treating PTSD.) The "but" is IMO a mild form of WP:SYNTH, it implies that one recommendation contradicts the other when there's no indication in the report that that's intended. Loki (talk) 02:36, 19 June 2023 (UTC)

Sure, that works. I'll implement after the page restrictions get lifted — Shibbolethink ^{(♔ ♕)} 18:30, 20 June 2023 (UTC)

The words "insufficient evidence" actually do not appear anywhere in the entire report. Putting them in quotes is completely inappropriate. What it actually says is "On the basis of available evidence, no specific recommendation can be made." I can't fathom why it would be relevant to an encyclopedia article to point out that a report makes no recommendation one way or another about a particular treatment. If you insist that it is, please reword it to say something like "makes no recommendation." GreatBigCircles (talk) 18:30, 21 June 2023 (UTC)

It is a perfectly fine way to phrase it, and captures that they looked for evidence in support but didn't have it - your edit made it sound like they didn't evaluate evidence at all. I agree that the quote marks can be removed, though. MrOllie (talk) 18:50, 21 June 2023 (UTC)

How about "insufficient evidence to make a recommendation"? GreatBigCircles (talk) 18:56, 21 June 2023 (UTC)

Since I'm being accused on my user talk of ignoring this talk page, I will reiterate here that this edit is not reflective of the burgeoning consensus on this talk page. Adding wording supported only by yourself to someone else's talk page proposal is not how consensus support works. MrOllie (talk) 18:58, 21 June 2023 (UTC)

I agree that the quotes should be dropped, but otherwise I support the consensus version. There either is or isn't sufficient evidence, the current text tells it as it is without over-complicating the prose. Regards. Draken Bowser (talk) 19:52, 21 June 2023 (UTC)