Talk:Eye movement desensitization and reprocessing/Archive 7

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Alright everyone, let's figure out an RFC

At the suggestion of others, let's figure out an actual question for an RFC. Or at least try to come to some sort of consensus here, because I still don't get a sense that BC's changes have consensus. Loki (talk) 20:45, 20 March 2023 (UTC)

We don't need a RfC. RfC's are heavyweight processes which suck up editor time. Continue normal discussion here or at WP:FT/N. Continue finding and reading the WP:BESTSOURCES and make sure the article follows them. It need not be complicated. Also accept you need to WP:DROPTHESTICK wrt pseudoscience because nobody agrees with you. Bon courage (talk) 20:51, 20 March 2023 (UTC)

It's certainly not the case that nobody agrees with me. Or rather, it's at least certainly not the case that nobody disagrees with you; I'm perfectly willing to admit here that my original edit to reduce the prominence of pseudoscience in the article was not justified. Loki (talk) 20:54, 20 March 2023 (UTC)

Shibbolethink specifically I wanna ask: what exactly is your preferred option here? From my perspective, my options above were "the one I prefer", "the one I explicitly and strongly objected to", and "anything else". You described them as if I wanted both 1 and 2, which is emphatically not the case. Loki (talk) 20:53, 20 March 2023 (UTC)

Sorry I think you may have misunderstood (and I was not good at communicating my intention). I actually object to this entire framing. The options should have included more such as "characterized as Pseudoscience by experts" and "is considered pseudoscience". etc. and explicitly labeled those choices as such. It should have also had "is pseudoscience" as an option. But overall I do not think an RFC is warranted and the current status quo is fine with me. — Shibbolethink ^{(♔ ♕)} 14:59, 21 March 2023 (UTC)

Because the third RfC will be the charm, somehow? I suspect that this process is not well suited to capturing the shades of distinction that the topic calls for. XOR'easter (talk) 21:33, 20 March 2023 (UTC)

That's fine, I'm not married to the idea of an RFC. I just want to figure out what the actual consensus is here. So, what sort of shades of distinction are you talking about? Loki (talk) 21:39, 20 March 2023 (UTC)

The question should read ... "Where can I buy a purple hat?" -Roxy the dog 22:00, 20 March 2023 (UTC)

I'm not tracking the debate very well. But I believe EMDR is considered pseudoscience by relevant experts.DolyaIskrina (talk) 12:52, 21 March 2023 (UTC)

Seems to be what good sources say. If there's a good source considering the question and coming down against, I'd like to see it! Bon courage (talk) 13:07, 21 March 2023 (UTC)

It seems to be a split interpretation. One one side, a set of randomized control trials which found it to be effective (aka, it's "evidence based"). On the other side, critics of the RCT designs who typically point to a lack of foundational basis for why EMDR should work compared to other treatments (aka, it's not "science based"). There's major health organizations that recognize it as valid treatment, but also legitimate criticism that it lacks a scientific basis, so we need to balance both of those. Bakkster Man (talk) 15:22, 21 March 2023 (UTC)

It's the purple hat therapy problem. Something that kinds of works (most people agree) has been ginned up with some pseudoscience (most people agree). So it still "works", but it's a bit of a scam. That's what RS is objecting to. It's not really a "split" with different "sides". Bon courage (talk) 15:30, 21 March 2023 (UTC)

(ec)But how does the reader understand that without first knowing about EMDR "empirically supported treatment"? fiveby(zero) 15:33, 21 March 2023 (UTC)

To be clear, there's at least one expert we know of (McNally) who previously accused it of being a purple hat and now has changed his mind. And if you look at the studies they sometimes do consider this question as well, and often suggest that it's not. So it's definitely not a universal opinion that it's a purple hat (though it's common enough that I agree that should be represented in the article somewhere). Loki (talk) 15:34, 21 March 2023 (UTC)

Maybe more accurately described as the two underlying principles resulting in the difficulty explaining the situation. It's more of a continuum than sides, how much weight is placed in the RCTs (at the extreme, to the exclusion of underlying mechanisms) versus the various critiques. Bakkster Man (talk) 16:04, 21 March 2023 (UTC)

Do both. The RCTs are all shit AND it's considered pseudoscience. Nothing unexpected there! Bon courage (talk) 16:05, 21 March 2023 (UTC)

Do we have good secondary sources pointing to the RCTs being faulty? I think that would resolve any WP:RGW concerns with saying 'these public health bodies promote a pseudoscientific therapy'. Bakkster Man (talk) 16:20, 21 March 2023 (UTC)

Yeah, see all the sources under "Effectiveness". All the evidence is weak because of small / underpowered / flawed trials. Bon courage (talk) 16:34, 21 March 2023 (UTC)

Yeah, catching up with the article, I think we should be leading with the meta-analyses, or at least elevating their prominence. Though the current wording is definitely better than it was last week. Bakkster Man (talk) 17:34, 21 March 2023 (UTC)

I agree with Bakkster_Man. I don't think that it's "considered pseudoscience by relevant experts" unless the APA are somehow not relevant experts. Loki (talk) 15:31, 21 March 2023 (UTC)

Have they offered an opinion on the pseudoscience question? Bon courage (talk) 15:33, 21 March 2023 (UTC)

Do you think that the APA would endorse a therapy that they consider pseudoscience? Loki (talk) 15:34, 21 March 2023 (UTC)

Dunno. They have rules about what they endorse. EMDR gamed those rules. They endorse woo, yes. Bon courage (talk) 15:35, 21 March 2023 (UTC)

The question, right here illustrates the policy problem with your argument. Fact A (The APA endorsed it) does not lead to Fact B (It is not pseudoscience) without applying your own OR. MrOllie (talk) 15:50, 21 March 2023 (UTC)

Well, the intermediate step there is that the APA don't want to endorse pseudoscience. I'm reasonably confident it would be easy to source that part.

Look: if you are saying that the APA can fuck up, sure. I admit that. Even reliable sources eff up from time to time. But how do you know that your sources aren't cranks too? I could easily accuse them of that, and I doubt you would be able to come up with counter sources, because almost nobody ever says someone explicitly isn't a quack. Loki (talk) 16:20, 21 March 2023 (UTC)

I'm reasonably confident Yes, that is the OR. MrOllie (talk) 16:26, 21 March 2023 (UTC)

Do you want me to give you their evidence-based practice guidelines? Because "the APA cares about evidence-based practice" is absolutely a sourceable statement. Loki (talk) 16:30, 21 March 2023 (UTC)

No, because it would be irrelevant - what you're doing would still be WP:SYNTHESIS. MrOllie (talk) 16:39, 21 March 2023 (UTC)

Between what and what, and to produce what? Loki (talk) 16:40, 21 March 2023 (UTC)

Fact A (The APA endorsed it) does not lead to Fact B (It is not pseudoscience) without applying your own OR. MrOllie (talk) 17:14, 21 March 2023 (UTC)

But that's not what I'm claiming. I'm claiming that "The APA endorsed it" means it is not "considered pseudoscience by relevant experts" because the APA are relevant experts. Loki (talk) 17:22, 21 March 2023 (UTC)

Actually, I was at the meeting where the APA endorsed it. The view was: well, this is horseshit but our rules say we've got to endorse it because of those two 'positive' trials, crap as they are. Our hands are tied. Bon courage (talk) 17:24, 21 March 2023 (UTC)

It's still your interpretation. We have lots of experts who consider EMDR pseudoscience. We don't need to have every expert consider it pseudoscience for the statement to be verifiable. — Shibbolethink ^{(♔ ♕)} 16:37, 21 March 2023 (UTC)

Right, only those that consider the question. The "not EVERY sources says it's pseudosciance!" gambit is a well-worn fallacy here on Wikipedia. It should have a name. Bon courage (talk) 16:40, 21 March 2023 (UTC)

I understand that, but if you want to say that experts consider it pseudoscience you need to produce evidence that a majority do. Not just individual experts that do. To do otherwise is WP:SYNTH. Loki (talk) 16:42, 21 March 2023 (UTC)

If RS says it's pseudoscience we just assert it's pseudoscience. Basic WP:YESPOV. Sources that don't consider the question are irrelevant. Bon courage (talk) 16:44, 21 March 2023 (UTC)

SYNTH would be if we took critics saying "EMDR sucks!" and used it to support "EMDR has been characterized by experts as pseudoscience." As long as we aren't saying "majority" we don't need to produce any RSes which support "majority." — Shibbolethink ^{(♔ ♕)} 17:01, 21 March 2023 (UTC)

But saying "Experts think it's pseudoscience" implies a majority of experts do. I'm fine with saying "Some experts think it's pseudoscience" because that's well-sourced, but I don't think we currently have any sources whatsoever that it's the consensus in the field. Loki (talk) 17:05, 21 March 2023 (UTC)

This is correct. But we don't say what "experts think" because that's kind of strange. We just reflect RS. Personally I think we should just say it IS pseudoscience. Bon courage (talk) 17:07, 21 March 2023 (UTC)

LokiTheLiar, all you are doing here is hardening opinion against your views. There could be some really good content here if someone is willing to write it, but who would want to do that while all this is going on? fiveby(zero) 16:08, 21 March 2023 (UTC)

Could you please explain what I'm doing wrong here? I think that this is a good and reasonable argument. I'm definitely not being more argumentative than anyone else here, right?

Like, I understand that I and BC have fundamentally opposed views on what the sources mean. I don't think that I am likely to persuade them directly. But I don't want to just stop presenting my view while BC is presenting theirs because I don't want their view to come across as uncontested. Loki (talk) 16:15, 21 March 2023 (UTC)

I don't know if we do have opposed views on what the sources mean. But you want to take source A and source B and apply some kind of thought process to arrive at position C (which neither source directly supports). That's WP:SYNTHESIS and verboten by core policy. As other have said - you're just not WP:LISTENing. Bon courage (talk) 16:30, 21 March 2023 (UTC)

I understand that you think that making basic inferences like "experts with a history of evidence based practice try not to endorse pseudoscience" is WP:SYNTH, but it's explicitly not. (Also to be clear, I also understand that this doesn't really resolve the purple hat question or the question of whether EMDR has a good theoretical basis, and I'm not claiming that. I am not claiming that the APA endorsing something means that the criticism doesn't exist. I'm claiming that major medical organizations are medical experts, so that means that if they endorse something it's not accurate to claim "experts think it's pseudoscience" with no qualifier.) Loki (talk) 16:39, 21 March 2023 (UTC)

Interesting claim. Wrong mind. You can still (just) get homeopathy on the NHS. In any case, deploying such reasoning violates WP:NOR so it's a non-starter for you. Bon courage (talk) 16:41, 21 March 2023 (UTC)

That's fair, and I agree that's a reason for discarding the opinion of the NHS, because that's a pretty egregious mistake. But we're not just talking about the NHS here. You can't say that newspapers are inaccurate because a newspaper said something false once. Loki (talk) 16:44, 21 March 2023 (UTC)

The point is you can't use the availability of something (or not) from some health channel, or its endorsement therein, to reason about whether or not it's pseudoscience. Follow RS on the matter, not your own thoughts. Bon courage (talk) 16:46, 21 March 2023 (UTC)

Do you think that an organization composed of medical experts is equivalent to "some health channel"?

The reason I keep asking that is that the APA etc etc are RSes, and the fact that you keep on trying to ignore them means that it's you that is following your own thoughts rather than the RSes. Loki (talk) 17:07, 21 March 2023 (UTC)

If you had a citation from the APA that said something like 'EMDR is not pseudoscience' you'd have a point here, but you don't have that. Ignoring sources that are irrelevant to the question is exactly what should be done. MrOllie (talk) 17:20, 21 March 2023 (UTC)

Alright, so, now we're getting somewhere. My problem with this logic is that I think there are very few sources that will ever say that something is explicitly not pseudoscientific.

So for example, I think it's going to be hard to find sources that say even something like "the theory of relativity is not pseudoscientific". Would you accept sources that say "EMDR is evidence-based"? Or maybe "science-based"? Loki (talk) 17:25, 21 March 2023 (UTC)

Is there doubt about the Theory of Relativity? I think not. Acupuncture is more like it. For a while sources DID say it wasn't pseudoscience. But that changed. Bon courage (talk) 17:28, 21 March 2023 (UTC)

I think you have the timeline backwards. The sources that are most doubtful are also mostly the oldest. Meanwhile I can find significant numbers of more recent sources that call it an evidence-based treatment for PTSD: https://scholar.google.com/scholar?as_ylo=2019&q=emdr+%22evidence-based%22&hl=en&as_sdt=0,14

Some notable sources are this one from 2021, this one from 2020, and this one from 2022, among others. Loki (talk) 17:34, 21 March 2023 (UTC)

You're back on the OR again. Bon courage (talk) 17:36, 21 March 2023 (UTC)

How is citing sources OR? Loki (talk) 17:38, 21 March 2023 (UTC)

Oh wait, you mean about the timeline thing. My apologies. I agree that's OR, but I think your interpretation of the timeline is also OR. Until we get a source that directly addresses it we don't have anything but OR. Loki (talk) 17:39, 21 March 2023 (UTC)

And we have lots of recent sources which also describe it as having low evidence-quality, methodological problems, etc. That's why we say "controversy". — Shibbolethink ^{(♔ ♕)} 17:35, 21 March 2023 (UTC)

I agree! I think that saying "Some experts think EMDR is a purple-hat therapy..." is justified, and even "Many experts..." might be justifiable. But if you just say "Experts think" that implies "Experts agree that", and that's definitely not true. Loki (talk) 17:38, 21 March 2023 (UTC)

@LokiTheLiar we have an entire policy/guideline about this. WP:FRINGE. It tells us to describe, using WP:RSUW, what experts think about a topic. We have done that. We also describe there is controversy about the practice. Saying "experts consider it pseudoscience" is a reflection of WP:RSUW. There is no part of WP:RSUW that requires there to be a majority of experts who think that. — Shibbolethink ^{(♔ ♕)} 17:34, 21 March 2023 (UTC)

I understand that but I feel that the policy that applies here is 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.

This seems to me to be exactly the situation here and therefore we should not describe EMDR as unambiguously pseudoscientific. It's that that I object to, I am perfectly fine with portraying the criticism. Loki (talk) 17:42, 21 March 2023 (UTC)

In what ways do we do so "unambiguously" ? I've edited the statement to say "some experts." Is this sufficient to alleviate your concerns? — Shibbolethink ^{(♔ ♕)} 17:52, 21 March 2023 (UTC)

Yep! Loki (talk) 21:20, 21 March 2023 (UTC)

It's not a contest between your view and BC's on the sources. I think the editors who responded with qualified comments and saying the RfC's where premature are experienced and well-aware of issues. Give them some credit in that they do understand your view. I've done quite a bit of reading here and could flood the talk page with sources along the lines you have, but everyone already knows this so give them some space to think about it and respond. fiveby(zero) 17:23, 21 March 2023 (UTC)

Ah, gotcha. Loki (talk) 17:25, 21 March 2023 (UTC)

Personally I think noticeboards do better than RfCs. Have them rank the best sources and look at the consensus from those and the editors and use those to determine how much weight the term has from less involved editors. DN (talk) 01:37, 22 March 2023 (UTC)

See WP:FT/N#EMDR. Bon courage (talk) 06:39, 23 March 2023 (UTC)

Guidelines

I think someone who knows how should reread the guidelines and summarize (WP:MEDRS is i think misleading in implying i'm qualified to do that). For instance i don't see a recommendation in the WHO guidelines), we cite the glossary, but i can't find the supposed recommendation for stress, only On the basis of available evidence, no specific recommendation can be made about stand-alone problem-solving counselling, eye movement desensitization and reprocessing (EMDR), relaxation or psycho-education for adults with acute traumatic stress symptoms associated with significant impairment in daily functioning in the first month after a potentially traumatic event.. All this "adult", "adolescent", "child", PTSD vs. clinically significant PTSD and recommendation for use beyond PTSD is confusing. Also International Society for Traumatic Stress Studies looks like a professional body and not an standards body. fiveby(zero) 18:37, 21 March 2023 (UTC)

Ahh, "no recommendation for "Acute traumatic stress symptoms" but EMDR suggested for "Posttraumatic stress disorder" (Recommendations 14 and 15). fiveby(zero) 18:51, 21 March 2023 (UTC)

ooooh re: WHO. I didn't look at that. Will add. Will simplify the others. Professional bodies are typically used re: WP:MEDASSESS. Re the WHO, it's actually page 8 where they say:

Recommendation 14
Individual or group cognitive-behavioural therapy (CBT) with a trauma focus, eye movement
desensitization and reprocessing (EMDR) or stress management should be considered for adults
with posttraumatic stress disorder (PTSD).
Strength of recommendation: standard
Quality of evidence: moderate for individual CBT, EMDR; low for group CBT, stress management

and page 9:

Recommendation 15
Individual or group cognitive-behavioural therapy (CBT) with a trauma focus or eye movement
desensitization and reprocessing (EMDR) should be considered for children and adolescents with
posttraumatic stress disorder (PTSD).
Strength of recommendation: standard
Quality of evidence: moderate for individual CBT, low for EMDR, very low for group CBT

— Shibbolethink ^{(♔ ♕)} 18:54, 21 March 2023 (UTC)

I think part of the pseudoscience is extending to treatment beyond the EST, to children, beyond PTSD, etc. so important to get right, but sorry to dump it on you to fix. fiveby(zero) 19:03, 21 March 2023 (UTC)

The Skeptic Encyclopedia of Pseudoscience entry (now cited) is well worth reading. It discusses in detail the switcheroo tactic of how EMDR kept changing to take training money (for no good reason). But one of the real reasons it's so reviled as pseudoscience is it claim to be a revolutionary treatment that could help bring about world peace and cure AIDS and cancer, all off the back of some flimsy trials. Hence the comparison with animal magnetism. Bon courage (talk) 06:44, 23 March 2023 (UTC)

The source doesn't cite its own sources, tho, so it's hard to tell what the actual evidence is for this claim. No other source, including the ones that criticize it strongly, says that Shapiro believed that it was effective for anything but mental illness. Loki (talk) 12:19, 23 March 2023 (UTC)

Didn't say it was Shapiro herself making these claims. It's a good source for the pseudoscience stuff (sources don't need to "cite their sources" to the satisfaction of Wikipedia editors). Bon courage (talk) 13:23, 23 March 2023 (UTC)

Bibliography

Meta-Analyses

Oxford Posttraumatic Stress Disorder (PTSD) Chris Brewin UCL

• Bisson, Jonathan I.; Anke Ehlers; Rosa Matthews; Stephen Pilling; David Richards; Stuart Turner (2007). "Psychological treatments for chronic post-traumatic stress disorder: Systematic review and meta-analysis" (PDF). British Journal of Psychiatry (190): 97–104.
• Bryant, Richard (2011). "Psychological interventions for trauma exposure and PTSD". In Dan J. Stein; Matthew J. Friedman; Carlos Blanco (eds.). Post-traumatic stress disorder. pp. 171–215.

Systematic Reviews

Both old. We shouldn't use anything more than 5 years old if newer is available per WP:MEDRS (some exception apply e.g. Cochrane). Bon courage (talk) 15:15, 23 March 2023 (UTC)

Arghh, that's my go to when there are too many sources and need a filter, look for the bibliographies and literature surveys, but can see how maybe not appropriate in a MEDRS context. Oxford Bibliographies does keep updating the online version. fiveby(zero) 15:34, 23 March 2023 (UTC)

Recent Revert

@Roxy the dog, what is your objection to my edit? Loki (talk) 17:36, 3 April 2023 (UTC)

The huge change to POV, as I have already told you. - Roxy the dog 17:40, 3 April 2023 (UTC)

• I think edit-warring to alter the lede to say offhandedly "Despite evidence for its effectiveness ..." without qualification as to that "effectiveness" (not really effective), is WP:PROFRINGE/WP:POV. After the recent warnings given at ANI I am surprised to see this. Bon courage (talk) 17:53, 3 April 2023 (UTC)

  But that line is referring to the sentence literally directly before it where we explicitly note that large professional organizations consider it effective. And we have lots and lots of sourcing, including many of the critical sources that you yourself added, saying the same thing in basically the same terms. Loki (talk) 18:34, 3 April 2023 (UTC)

  See our "Effectiveness" section. The lede should summarize the body, not undermine it. Bon courage (talk) 18:37, 3 April 2023 (UTC)

  I think you think that section is a lot more negative than it actually is if you're saying that. We list countless professional organizations that agree that EMDR is effective, and also say that several RCTs have found it to be effective, though those RCTs have been criticized for methodological flaws. Even critics agree that it is an effective therapy. Loki (talk) 18:42, 3 April 2023 (UTC)

  We list countless professional organizations that agree that EMDR is effective That does not match my reading of the article at all. MrOllie (talk) 19:15, 3 April 2023 (UTC)

  It also does not match my reading. Methinks @LokiTheLiar should consider what amount of bias their perspective may be bringing to their own interpretation of the section. Pot, meet kettle. — Shibbolethink ^{(♔ ♕)} 04:09, 4 April 2023 (UTC)

  Agree, it's just wrong. Think is's time for the WP:STICK to be dropped on this: it's has been to umpteen noticeboards and the general consensus is clear that we've got the framing of this WP:FRINGE topic pretty spot on. Bon courage (talk) 04:22, 4 April 2023 (UTC)

  I was at a work computer before, but now I'm home I can show you some direct quotes from a source you added (Science and Pseudoscience in Clinical Psychology) which support the Despite evidence for its effectiveness language (emphasis mine):

  The scientific literature on EMDR supports several conclusions: (1) EMDR is an efficacious treatment for PTSD, (2) the efficacy of EMDR is comparable with that of trauma-focused CBT approaches such as PE, and (3) eye movements and other bilateral stimulation techniques appear to be unnecessary and do not uniquely contribute to clinical outcomes

  and later

  Despite its status as an evidence-based psychotherapy that is recommended as a first-line treatment for PTSD in clinical guidelines (e.g., Department of Veterans Affairs/Department of Defense, 2010), EMDR offers few, if any, demonstrable advantages over competing evidence-based psychological treatments. Moreover, its theoretical model and purported primary active therapeutic ingredient are not scientifically supported.

  And this is one of the more critical sources in the article. Other sources usually describe it similarly. So for example, the APA in its Clinical Practice Guideline for PTSD describes it as one of a core set of evidence-based psychotherapies for adults with PTSD. The DoD's Clinical Practice Guideline for PTSD describes it as one of the trauma-focused psychotherapies with the strongest evidence from clinical trials. Per WP:MEDORG these are very strong WP:MEDRS sources and I'm very frustrated that this article doesn't acknowledge what appears to be a clear consensus even among critics of EMDR. Loki (talk) 05:26, 4 April 2023 (UTC)

  Nice WP:CHERRYPICKING. But we need to summarize sources accurately. Anyway, since the WP:STICK waving is now getting disruptive I'll bow out here but keep watching the article itself for any further POV problems. Bon courage (talk) 05:33, 4 April 2023 (UTC)

  I could similarly accuse you of WP:CHERRYPICKING and WP:STICK-waving. Your ability to find a book that says that EMDR is pseudoscience does not outweigh several other strong sources that say EMDR is evidence-based.

  I think out of any single source, the WHO probably has the best summary of the full picture when they say there's moderate evidence for its effectiveness in treating PTSD in adults but controversy over its theoretical mechanism. But no source, even a very strong source like the WHO, is governing alone. We need to include all the reliable sources: both the critical ones and the positive ones, both of which there are quite a few of. Loki (talk) 06:35, 4 April 2023 (UTC)

Roxy, I was specifically trying to be careful to not change the overall POV of the lede in that edit. What change to POV do you think I made, and why? Loki (talk) 18:37, 3 April 2023 (UTC)

Clearly, you didn't try very hard to not change POV. - Roxy the dog 18:41, 3 April 2023 (UTC)

Are you or are you not going to explain your objection? Loki (talk) 18:42, 3 April 2023 (UTC)

The first sentence you changed is a major change in POV, for which there is no consensus. Not having it. - Roxy the dog 18:44, 3 April 2023 (UTC)

The first sentence I changed was splitting EMDR combines exposure therapy (recalling distressing experiences) with certain eye movements that have been criticized as having no scientific basis into EMDR involves focusing on traumatic images while moving one's eyes back and forth, and also moving the criticism to the bottom paragraph in the sentence The eye movements have been criticized as having no scientific basis.

If you missed the fact that the criticism was still there, I could definitely see why you thought the edit was POV. But I didn't delete it, I just moved it. In fact, I added a bunch of extra criticism that was previously in the body but not the lead, and deleted a long quote that was previously the most positive part of the lead. Loki (talk) 19:05, 3 April 2023 (UTC)

Grouping all of the criticism at the end is also a form of POV, as is removing the criticisms from context in which they originally appeared. - MrOllie (talk) 19:14, 3 April 2023 (UTC)

Wikipedia's style guides pretty heavily recommend against piling criticism into one single section in a place different and out of context from praise/support. It neuters the criticism, makes it less likely to be read, and bolsters FRINGE POV. Do not do this. — Shibbolethink ^{(♔ ♕)} 04:10, 4 April 2023 (UTC)

You... are right, actually. I mean, I don't agree that's that's the reason why the guidelines recommend against it, but I agree that they do, and that it's a good argument against organizing the lead like that.

According to WP:CRIT, the reason criticism sections should be avoided is because these sections call undue attention to negative viewpoints and the table on them specifically mentions that Great care should be taken that the section is not an WP:INDISCRIMINATE list of complaints. Or in other words, the worry is basically the opposite of what you've said it is: it's that criticism sections give criticisms undue WP:WEIGHT and can become a dumping ground for criticisms that are weakly sourced or otherwise not particularly notable. (And in fact, that's the main failure mode I've personally seen: BLPs with a "Criticism" section that amounts to a bunch of unverified rumors.)

But regardless, you're definitely right that they're not best practice. In this case, my reason for doing so is that I thought it was clearer to separate the criticisms from the description of the practice of EMDR. I still think the current lead is very suboptimal, especially because it describes what EMDR actually is in the first place twice: once in Wikivoice and once in the form of a long quote. Loki (talk) 05:01, 4 April 2023 (UTC)

I still think the current lead is very suboptimal, especially because it describes what EMDR actually is in the first place twice: once in Wikivoice and once in the form of a long quote
Yep, so why don't we get rid of the long WP:UNDUE quote? — Shibbolethink ^{(♔ ♕)} 19:46, 4 April 2023 (UTC)

I don't think the quote is WP:UNDUE, though. It's from the WHO, it's probably the weightiest single source in the article. I'd rather just integrate it into our existing description of what EMDR does. Loki (talk) 20:28, 4 April 2023 (UTC)

If it is redundant, what is there to integrate? What does it convey that the other description doesn't? MrOllie (talk) 20:32, 4 April 2023 (UTC)

It explains what supporters think the theoretical basis is, and also describes that the side to side movements are not necessarily eye movements.

It's also, frankly, a lot more neutral than what we currently have. Loki (talk) 20:36, 4 April 2023 (UTC)

It's also, frankly, a lot more neutral than what we currently have

This appears to be your personal opinion. It's not the consensus on this page. — Shibbolethink ^{(♔ ♕)} 21:41, 4 April 2023 (UTC)

Australian Medical Guidelines

I object to MrOllie's suggestion to take this to the talk page or removing of the guideline in the meantime, because it's actually an extremely clear case. This is the guideline in question and it says on page 5 straight out that:

Strong recommendation FOR EMDR
For adults with PTSD, we recommend eye movement desensitisation and reprocessing (EMDR).

This is not a conditional recommendation for EMDR, as we had said previously. That language comes from the recommendations for children on page 3. And it's a national recommendation so per WP:MEDORG it's highly reliable and therefore has a large amount of WP:WEIGHT. Loki (talk) 20:35, 4 April 2023 (UTC)

It also says Conditional recommendation FOR brief EMDR For adults with PTSD symptoms in the first three months following trauma, we suggest offering brief EMDR in preference to doing nothing. The link is just to an executive summary. Does anyone have access to the full document? MrOllie (talk) 20:43, 4 April 2023 (UTC)

This appears to be a document from "Phoenix Australia". What's that? I think this[1] is the actual doc. Bon courage (talk) 20:44, 4 April 2023 (UTC)

Full document has some interesting stuff! Over time, EMDR has increasingly included more treatment components that are comparable with the cognitive behavioural therapy (CBT) interventions described below. These include [...] EMDR now includes most of the core elements of standard trauma-focussed CBT (TF-CBT)and then There are six studies directly comparing CBT to EMDR and the evidence suggests that the two variants of trauma-focussed therapy are not statistically different. MrOllie (talk) 21:02, 4 April 2023 (UTC)

Yeah, no kidding. It certainly is a very good find. Loki (talk) 21:06, 4 April 2023 (UTC)

Good find. That fuller document says very early on that For adults who develop PTSD, the best approach to treatment is trauma-focussed cognitive behavioural therapy (TF-CBT) or eye movement desensitisation reprocessing (EMDR). Their official recommendation on page 91 is grade A and states Adults with PTSD should be offered trauma-focussed cognitive behavioural interventions A or eye movement desensitisation and reprocessing. Loki (talk) 21:05, 4 April 2023 (UTC)

What does "grade A" mean? - Roxy the dog 21:08, 4 April 2023 (UTC)

The definition is on page 2:

Guideline recommendations arising from the systematic review are graded according to the NHMRC grading system (NHMRC, 2005):

• Grade A: Body of evidence can be trusted to guide practice
• Grade B: Body of evidence can be trusted to guide practice in most situations
• Grade C: Body of evidence provides some support for recommendation(s) but care should be taken in its application
• Grade D: Body of evidence is weak and recommendation(s) must be applied with caution

Or the TL;DR is, it's their highest grade of evidence. Loki (talk) 21:16, 4 April 2023 (UTC)

I think a fair summary of this would include that it is as an alternative to no treatment since that is not the usual alternative. It also should not omit the fact that the guideline basically offers EMDR as an alternative to CBT, noting that the version of EMDR recommended and CBT are essentially the same except for some eye movements. — Shibbolethink ^{(♔ ♕)} 21:50, 4 April 2023 (UTC)

I'm not sure what the usual alternative would be here or how this is different.

It's reasonable to note that the version of EMDR recommended is very similar to CBT, but "essentially the same" other than the eye movements is a little too strong, IMO. That paragraph does still allow for some differences other than the eye movements (e.g. EMDR only includes "analogous" or "comparable" practices, EMDR only includes "most" of the core features of CBT, EMDR's claimed theoretical basis is still different).

On that note, while I'm not sure the article should include it, the source also does include this very relevant paragraph: In this process one significant difference of opinion arose. A member of the multidisciplinary panel objected to the inclusion of a good practice point (GPP) that indicated that eye movements per se had not been proven to have any active effect in the efficacy of eye movement desensitisation and reprocessing (EMDR). A vote was taken within the working party in relation to this issue and it was agreed that this GPP should be removed as the question of mechanisms of treatment had not been specifically addressed in the evidence review nor addressed in the recommendations pertaining to any other intervention. One member of the working party dissented from this view given the purported centrality of the eye movements to EMDR as reflected in its title. Loki (talk) 22:34, 4 April 2023 (UTC)

I'm not sure what the usual alternative would be here

The usual alternative in any high quality RCT or systematic review is the standard of care (in this case, CBT and graduated exposure therapy.) — Shibbolethink ^{(♔ ♕)} 22:35, 4 April 2023 (UTC)

In these medical recommendations, the point is establishing what the standard of care is, so I don't think that's true in this situation. If they assumed that CBT was the standard of care in order to recommend (among other things) CBT, that would be circular reasoning. Loki (talk) 22:42, 4 April 2023 (UTC)

It has been characterized by some experts

I cannot find the consensus for the word "some" that is alleged to be somewhere on this page. --Hob Gadling (talk) 13:37, 9 April 2023 (UTC)

Neither can I find the alleged exception in WP:WEASEL. It does say, They may also be used in the lead section of an article or in a topic sentence of a paragraph, and the article body or the rest of the paragraph can supply attribution but that seems to only apply if there is a reliable source that explicitly says "some". --Hob Gadling (talk) 13:40, 9 April 2023 (UTC)

Consensus I'm referring to was the In what ways do we do so "unambiguously" ? I've edited the statement to say "some experts." Is this sufficient to alleviate your concerns? by Shibbolethink, and the discussion above it. (Sorry, there's been a lot of talking on this page.)

Also, you're conflating two sentences. The guideline is The examples above are not automatically weasel words. They may also be used in the lead section of an article or in a topic sentence of a paragraph, and the article body or the rest of the paragraph can supply attribution. Likewise, views that are properly attributed to a reliable source may use similar expressions, if those expressions accurately represent the opinions of the source. This is an example of the lead section summarizing the body, which is a separate exception from weasel-like phrases attributed to a specific reliable source. Loki (talk) 18:41, 9 April 2023 (UTC)

I think "some" was just a compromise. But I agree, it is unnecessary. We just say "experts consider it..." Because experts, in our sources, do. "Some" is a bit WEASEL-y, but it's better than having endless disruption. We need to settle on a consensus wording.

Omitting the sentence entirely is a non-starter, because it runs afoul of FRINGE. Over-attributing it dilutes the criticisms and thereby violates NPOV and summary-style of the lead. "some" is perhaps the least of all evils that settles the dispute. But yes, it is truly a WEASEL phrasing. — Shibbolethink ^{(♔ ♕)} 15:45, 11 April 2023 (UTC)

Perhaps we should stop shilly-shallying and just say it is pseudoscience, like the relevant sources. Trying to be "soft" for the sake of editors squeamishness seems to have backfired. Bon courage (talk) 15:54, 11 April 2023 (UTC)

The "relevant sources" pretty explicitly do not say that. Only a handful do. Even on the direct question of whether the eye movements are relevant (and therefore whether it's reasonable to characterize it as a purple hat therapy, which again is different from pseudoscience), sources disagree. We have that 2013 meta-analysis which says they are relevant, the Encyclopedia of Personality and Individual Differences source I added earlier says there's some evidence that they are relevant, and the US Department of Veteran's Affairs also says that Some research shows that the back and forth movement is an important part of treatment, but other research shows the opposite. We also have, on that topic, the NYT interview with McNally where he says he's changed his mind on the eye movements and thinks they are useful.

And furthermore there's all those sources I've already linked which call the therapy as a whole "evidence-based", so regardless of whether you're talking about the eye-movements specifically or the treatment as a whole it's very much not the case that the sources agree on characterizing it as pseudoscientific. They are closer to agreeing on the opposite, if anything.

(Also, while this is a direct reply to BC, I also mean it as a reply to Shibbolethink. The "some" really is necessary because it's only some experts that think it's even a purple-hat therapy.) Loki (talk) 01:58, 12 April 2023 (UTC)

"agree with your "it's very much not the case that the sources agree on characterizing it as pseudoscientific. They are closer to agreeing on the opposite, if anything." JCJC777 (talk) 09:58, 13 April 2023 (UTC)

There is also Bessel van der Kolk, the trauma researcher and author of The Body Keeps the Score that supports EMDR per this article, his book, and several other sources. — Preceding unsigned comment added by Cedar777 (talk • contribs) 11:16, 12 April 2023 (UTC)

thanks and well done

Just wanted to say thanks and well done to editors Cedar777‎ Loki Shibbolethink Bon courage and MrOllie for work on this [difficult] article. really feel things are moving forward now.JCJC777 (talk) 11:24, 12 April 2023 (UTC)

Well no, because you keep blanking content and have edit warred again to get to the current state of the article. Editors are reminded this is a WP:CTOP. Bon courage (talk) 11:27, 12 April 2023 (UTC)

I mean, if they've edit warred, so have you. You've reverted several recent edits to the page, often ones that contained at least some uncontroversial additions. There's no exception to the edit warring policy for believing that you're right in a content dispute. :P

(Just to be explicit, I think that it's not accurate to describe either side of this content dispute as edit warring as of right now, and that for the most part recent edits have been constructive. I still don't like the big indiscriminate reverts though.) Loki (talk) 22:43, 12 April 2023 (UTC)

There would probably be fewer large reverts if there were fewer undiscussed deletions and mass rewrites. MrOllie (talk) 22:51, 12 April 2023 (UTC)

So, I have been trying to make smaller edits recently as a defense against getting reverted for something I felt was minor, but it's also not an exception to the edit warring policy that the other side has been making large edits. Loki (talk) 23:34, 12 April 2023 (UTC)

Well, only one person broke the 3RR today, and it wasn't either of us or Bon courage. Don't take it personally. MrOllie (talk) 23:37, 12 April 2023 (UTC)

Editing repeatedly against consensus as a way to insert one's own POV is also a violation of wikipedia's guidelines. It doesn't even need to violate the "bright line" of 3RR to be a blockable offense. A long-term pattern of attempting to insert one's own POV into an article against consensus is still edit warring. It's still disruptive. — Shibbolethink ^{(♔ ♕)} 17:10, 13 April 2023 (UTC)

To understand why this article is dysfunctional, look at the edit history. It was fairly stable until March 2023. Then a precedent was set for massive reverts without any input or consensus building. On March 20-21 we have Bon courage making 50 edits. This was followed by Shibbolethink making 30 edits on March 21 alone. What does this demonstrate about one's respect for WP:3RR? Cedar777 (talk) 18:10, 13 April 2023 (UTC)

Bugger all. It demonstrates a lack of understanding that multiple contiguous edits count as one (but can be done courteously as many to afford explanatory edit sumamries). If 3RR has been broken, report it. Blathering on misleadingly about process with snide insinuations is disruptive. Bon courage (talk) 18:17, 13 April 2023 (UTC)

The 3RR is a special case of the overall edit warring policy, and it is a violation of the edit warring policy as a whole to repeatedly revert a page to the version you think is "good" over several days or weeks without discussion.

But again, I (mostly) don't think an actual edit war is happening right now, because a revert is about directly undoing previous edits. It's not edit-warring for me to add a source and then for you to add a contradictory source, and so on and so forth. As long as edits change different parts of a page like this, it's possible to go back and forth as long as you like with someone you disagree with, and this is not an edit war but an important part of the process of editing. Loki (talk) 18:43, 13 April 2023 (UTC)