Scientific resistance to research, training and utilization of eye movement desensitization and reprocessing (EMDR) therapy in treating post-war disorders

Psychology, or more specifically psychotherapy, like any science, is a tale of the evolution of a body of knowledge by forward-thinking individuals whose creative endeavors often ran into fierce opposition, known as the zeitgeist of their times. Zeitgeist is originally a German expression meaning ‘‘the spirit of the age’’ (Mish, 1985; p. 1370). It describes the prevailing intellectual and cultural climate of an era, also sometimes referred to as dominant scientific ‘paradigms’ or ‘schools’. The history of scientific discovery is replete with individuals and ideas clashing with accepted mainstream zeitgeist.

Progression of science and prominence

Several studies have reviewed theoretical analyses on the development of science and issues of prominence or zeitgeist (Robins, Gosling, & Craik, 1999; Tracy, Robins, & Gosling, 2005). For example, Kuhn (1970) advocates that scientific prominence is defined by the amount of attention afforded to a particular school’s research findings and theories. Kuhn (1970) posits that science progresses from a ‘preparadigmatic’ stage with multiple competing schools that eventually merge into a ‘paradigmatic’ stage dominated by a single set of beliefs and methods, subject to replacement by successive paradigms. Lakatos (1970) viewed prominence as the extent of empirical support garnered for a particular school’s basic assumptions over multiple competing schools at a given time.

In contrast, Latour (1987) suggests that sociological factors determine dominance according to the degree research findings are disseminated through publications and conferences that attract attention and popularity. Similarly, in the case of psychology, scientific prominence has been likened to a ‘history of fads’ (Tracy et al., 2005) whereby dominance is relative to whichever theory is currently favored by the broader scientific and intellectual community as opposed to a specific schools’ ability to document scientific truths.

Adaptive functions of zeitgeist or resistance to change in science

The presence of predominant belief systems in a culture is adaptive; it provides individuals with a sense of coherence and organization to carry out their lives in society (Barber, 1961). Dominant belief systems provide necessary periods of stability allowing for assimilation and reflection to occur in order to adequately test or refine prevailing theoretical models. A zeitgeist can slow down change, thus avoiding a state of flux and chaos.

By forcefully challenging new ideas before accommodating them into mainstream academics and practice, a zeitgeist prevents current theories from being abandoned prematurely in favor of unproven innovations (Barber, 1961). Barber goes on to indicate that scientific innovations are therefore expected to receive some degree of opposition by fellow scientists, quoting Trotter to this effect: ‘‘the reception of new ideas tends always to be grudging and hostile’’ (Barber, 1961, p. 597).

Potential harmful effects of zeitgeist and resistance to scientific discovery

Just as having fixed belief systems can serve adaptive purposes for individuals, society and science, they may also cause harm by blinding members of society to alternative views. Such cultural blinders were all too apparent in Galileo’s case, but remain a constant source of resistance to any innovation despite formalized preventative methods and efforts by scientists (Barber, 1961). Intolerance can arise when a particular zeitgeist is threatened by unconventional models, leading to reflexive attacks aimed at preserving dominance.

Left unchecked, a scientific community and culture rigidly operating under a certain zeitgeist will reinforce its convictions by selective attention to confirmatory evidence and dismissal of contrary facts (Barber, 1961; Mahoney, 1977a). An entrenched bias can emerge when academic research and healthcare agencies align under a theoretical view erecting formidable barriers for rival models. The net result is a science insulated by functional blinders prohibiting unbiased development and testing of rival hypotheses, creativity and advancement.

Resistance to scientific change: a case study in the treatment of combat stress

With over 400 variations of psychotherapies practiced, efforts to identify the most efficacious or ‘evidenced-based treatments’ (EBT) for psychological conditions were initiated in the 1990s and were driven by converging trends of evidenced-based medicine, professional accountability and cost-containment (DeAngelis, 2005). In 2004, the US Department of Veterans’ Affairs and Department of Defense published clinical practice guidelines for treatment of traumatic stress (Department of Veterans’ Affairs/Department of Defense, 2004).

Four tier-one EBT were identified as providing significant benefit for post-traumatic stress disorder (PTSD): Cognitive Therapy, Exposure Therapy, Stress-Inoculation Training that will be collectively referred to as CBT and eye movement desensitization and reprocessing (EMDR; Department of Veterans’ Affairs/Department of Defense, 2004). These same psychotherapies have been recognized by the American Psychological Association, Division 12 (Chambless et al., 1998), the American Psychiatric Association clinical practice guidelines for PTSD (APA, 2004), Cochrane Review (Bisson & Andrew, 2007) and at least six meta-analyses (Bisson et al., 2007; Bradley, Greene, Russ, Dutra, & Westen, 2005; Davidson & Parker, 2001; Maxfield & Hyer, 2002; Seidler & Wagner, 2006; Van Etten & Taylor, 1998) as best evidence-based treatments for PTSD.

Prevailing controversy regarding EMDR therapy

Since coming onto the scene 18-years ago, EMDR has been mired in a ‘controversy’ between hardened antagonists and proponents of EMDR. EMDR appears to elicit three reactions from researchers, providers and the media alike: uncritical-over-zealous acceptance, appropriate skepticism-with an open-mind, or overly criticaldefensive posturing. Unfortunately, premature and irresponsible promotion of EMDR as a proven, ‘miraculous’ treatment for PTSD and any number of psychiatric conditions has significantly contributed to the scientific backlash.

However, with substantial empirical evidence now supporting EMDR as EBT-PTSD, arguments have shifted to proving hypothesized mechanisms of action such as alternating eye movements. Research isolating eye movements has proven inconclusive (i.e., Bisson & Andrew, 2007) leading numerous CBT scholars to proclaim EMDR as merely another CBT variant. However, if EMDR is conceptualized as a CBT variant, this contradicts the need for devaluing a kindred evidenced-based CBT as ‘mesmerism’ (McNally, 1999b), ‘crazy therapy’ (Singer & Lalich, 1996); ‘pseudo-science’ (i.e., Herbert et al., 2000), or ‘power therapy’ (i.e., Rosen, Lohr, McNally, & Herbert, 1998).

Resistance to scientific change: substantive concepts

According to Barber (1961), the ‘substantive concepts’ or adopted theoretical models held by scientists provide one type of cultural resistance to discovery. For example, in his analysis of the Copernican revolution, Kuhn describes the implacable resistance of Brahe, the leading astronomer of the time, who was unwilling to change his resolute belief concerning the earth’s stationary rotational status despite considerable evidence to the contrary. Brahe actively used his academic prestige to delay acceptance of the rival theory until his death.

Numerous instances abound of scientific innovations blocked by prevailing antagonists, even those with important medical implications impacting the health and well-being of others such as Pasteur’s fermentation process and Lister’s germ theory of disease (Barber, 1961). Francis Bacon was the first to describe ‘confirmatory bias’ in scientists defined as a tendency to seek out, attend to, and sometimes embellish experiences that support or confirm their beliefs and ignore disconfirming findings (Mahoney, 1977a).

Resistance to change: societies, ‘‘schools’’ and seniority

Scientific organizations serve important functions for members and professions, including scientific publications essential for communication in science. However, these same professional organizations can inadvertently maintain a particular zeitgeist by filtering information published in flagship periodicals or endorsed in practice guidelines. Barber (1961) states that professional rivalries or ‘schools’ can offer useful competition as well as scientific resistance.

That the older resist the younger in science is familiar pattern noted by scientists as far back as Bacon: ‘‘scientia inflate, and the dignitaries who hold high honors for past accomplishments do not usually like to see the current of progress rush too rapidly out of their reach’’ (Barber, 1961, p. 601). Mahoney (1977b) found substantial evidence that reviewers made more positive appraisals of manuscripts whose findings confirmed principles of behavioral therapy and more negative appraisals for identical manuscripts reporting findings that disconfirmed the same principles: an entrenched zeitgeist may well create publication prejudices.

 

Author: Mark C. Russell