I first heard of the Flash Technique (FT) in March 2019 when attending Dr. Philip Manfield’s therapy training on Eye Movement Desensitization and Reprocessing (EMDR) in Oakland, California. Unlike EMDR, FT does not require the client to commit to a lengthy process, nor does it require the client to focus on the traumatic memory for an extended period of time.
The FT process starts with the client’s identifying a memory or fear and ranking the level of disturbance they are feeling in that moment. The scale, which is known as SUDS (Subjective Units of Distress), ranges from 0-10, with 10 being the most disturbing. Next, I ask the client to think of something positive or exciting that they can talk about for the next 10-15 minutes (i.e., a hobby, a pet, a movie, a trip). This is known as the Positive Engaging Focus (PEF). When FT was first developed, the therapist would say “flash” while the client discussed the PEF and instructed them to briefly think of the target memory. It later became evident that this was not necessary, and now when the therapist says “flash,” the client is instructed to blink instead of flash on the target memory.
Once the PEF is identified, I demonstrate for the client how to cross their arms over their chest (a butterfly hug) and tap their arms. They tap while describing the PEF, during which time I periodically ask them to blink several times in rapid succession. After five or so sets of blinks, I ask them to pause and reflect on the target memory/fear. They rank the disturbance and tell me what they notice about the memory. Usually the target is less vivid and harder to pull up. Then we continue with the PEF accompanied by more blinking and tapping, after which we pull up the target again. This process continues until the target is no longer disturbing.
FT can be used as a part of EMDR treatment or on its own. I thought FT was an interesting tool and started using it along with the standard EMDR protocol. Sometimes I use FT to lower the intensity of the target, and then process the remainder by using traditional EMDR. My practice has been both online and in person, and I have used FT with both virtual and in-office clients. I have found no major difference between in-person or virtual use of FT. I show the client how to cross their arms and tap the same way virtually as I would do in person.
My interest in FT grew over time as I was observing positive results. As of this writing, I have used FT with dozens of clients for two years. I have found it easy to use and very effective when working on a variety of disturbing memories and fears. It usually takes about 15 minutes to implement FT, making it very easy to fit into the standard 50-minute session. In contrast to conventional trauma therapy interventions like EMDR, FT is minimally intrusive, in that it does not require the client to consciously engage with the traumatic memory. The client can therefore process traumatic memories without feeling distress.
In the following session, usually a week later, I recheck the target memory or fear to see if there is still any disturbance. Some targets resolve in one session and the results hold over time. Typically, the easiest cases are single-incident traumas—an event that took place at one time and does not have any related memories. For example, someone who was in a car accident once and developed a fear of driving can often process the incident in one session without any need for additional work. In other cases, usually where there are many related memories, it generally requires additional sessions of FT or EMDR to fully resolve them. Multiple incidents can also be processed but may require additional sessions.
I should note that FT, like EMDR, does not completely remove all fear. I would not want my clients to put themselves in unsafe situations following FT. Rather, FT and EMDR aim to relieve the extreme disturbance associated with a traumatic event. The client still remembers that the event took place and experiences a normal level of anxiety in appropriate situations. FT does not provide superpowers or magical thinking. It helps remove the irrational fear so that the client can comfortably engage in everyday activities. Below is a case example of my use of FT with a client who had been mugged.
Della, a 33-year-old Caucasian female, was mugged seven years ago on the street. Since then, she had been unable to walk alone at night. She always had to have someone walk her places after dark, or she avoided going out altogether. Della lived in a safe suburb and did not have an urgent need to go anywhere at night. She stated, “I want to be able to walk alone at night if I need to.” Recently, Della’s company offered to relocate her to Paris. She was excited about the opportunity but realized that she needed to work on this fear if she was going to move to a big city.
We discussed the mugging in more detail. The incident happened when she was in college. She was studying late at the library and drove home to her apartment at around 2 a.m. She had parked her car in a garage a block away from her apartment. As she was walking home, three people came up behind her, kicked her to the ground, grabbed her backpack containing a laptop, and drove away. When asked to rank the disturbance associated with this memory, Della stated it was a 9 on the SUD scale. For FT, we chose Paris as her PEF. “I’m excited to move there,” Della said. After five sets of FT which took about 10 minutes, Della ranked the SUD at 1 before the session ended.
Two weeks later, Della reported that she had chosen a safe area in her suburb as a test for an evening walk. She walked alone at around 8 p.m. Della stated, “This is something I haven’t been able to do since the mugging seven years ago.” She said that it felt good to walk around and look at the lights. “This time, I didn’t have any physical symptoms,” said Della. She described that she did feel a little nervous, ranking the SUD at 1-2. However, it felt like a normal amount of anxiety compared to the paralyzing fear she had experienced previously. She felt good about the outcome. “I wanted to be able to walk alone at night if I had to, and now I can do that,” Della remarked.
In addition to the previous case, I have successfully used FT with other clients, focusing on a variety of negative memories and fears. Some examples include a parent’s suicide, childhood bullying, extreme fear of bugs, chronic pain with fear of becoming disabled, fear of contracting COVID-19, sexual assault, car accident/fear of driving, and near drowning/fear of swimming. In some cases, the problem resolved after only 15 minutes of FT, with no resurgence. In other cases, FT provided some benefit, but additional EMDR work was required to fully re-process the event and maintain results over time. To date, I haven’t observed any negative experiences with FT. Most clients have found FT to be helpful and enjoyable. I should note that FT, like any therapeutic intervention, may not be effective for every client or situation. Clients should be aware of potential risks and limitations of FT before starting therapeutic treatment.
Useful Articles Related to the Flash Technique:
EMDR and The Flash Technique: A Match Made in Heaven?
Helping Adults and Children to Recover from Trauma with a Gentle Flash
Manfield, P., Lovett, J., Engel, L., & Manfield, D. (2017). Use of the flash technique in EMDR therapy: Four case examples. Journal of EMDR Practice and Research, 11(4), 195–205.
File under: The Art of Psychotherapy
The FT process starts with the client’s identifying a memory or fear and ranking the level of disturbance they are feeling in that moment. The scale, which is known as SUDS (Subjective Units of Distress), ranges from 0-10, with 10 being the most disturbing. Next, I ask the client to think of something positive or exciting that they can talk about for the next 10-15 minutes (i.e., a hobby, a pet, a movie, a trip). This is known as the Positive Engaging Focus (PEF). When FT was first developed, the therapist would say “flash” while the client discussed the PEF and instructed them to briefly think of the target memory. It later became evident that this was not necessary, and now when the therapist says “flash,” the client is instructed to blink instead of flash on the target memory.
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Once the PEF is identified, I demonstrate for the client how to cross their arms over their chest (a butterfly hug) and tap their arms. They tap while describing the PEF, during which time I periodically ask them to blink several times in rapid succession. After five or so sets of blinks, I ask them to pause and reflect on the target memory/fear. They rank the disturbance and tell me what they notice about the memory. Usually the target is less vivid and harder to pull up. Then we continue with the PEF accompanied by more blinking and tapping, after which we pull up the target again. This process continues until the target is no longer disturbing.
FT can be used as a part of EMDR treatment or on its own. I thought FT was an interesting tool and started using it along with the standard EMDR protocol. Sometimes I use FT to lower the intensity of the target, and then process the remainder by using traditional EMDR. My practice has been both online and in person, and I have used FT with both virtual and in-office clients. I have found no major difference between in-person or virtual use of FT. I show the client how to cross their arms and tap the same way virtually as I would do in person.
My interest in FT grew over time as I was observing positive results. As of this writing, I have used FT with dozens of clients for two years. I have found it easy to use and very effective when working on a variety of disturbing memories and fears. It usually takes about 15 minutes to implement FT, making it very easy to fit into the standard 50-minute session. In contrast to conventional trauma therapy interventions like EMDR, FT is minimally intrusive, in that it does not require the client to consciously engage with the traumatic memory. The client can therefore process traumatic memories without feeling distress.
In the following session, usually a week later, I recheck the target memory or fear to see if there is still any disturbance. Some targets resolve in one session and the results hold over time. Typically, the easiest cases are single-incident traumas—an event that took place at one time and does not have any related memories. For example, someone who was in a car accident once and developed a fear of driving can often process the incident in one session without any need for additional work. In other cases, usually where there are many related memories, it generally requires additional sessions of FT or EMDR to fully resolve them. Multiple incidents can also be processed but may require additional sessions.
I should note that FT, like EMDR, does not completely remove all fear. I would not want my clients to put themselves in unsafe situations following FT. Rather, FT and EMDR aim to relieve the extreme disturbance associated with a traumatic event. The client still remembers that the event took place and experiences a normal level of anxiety in appropriate situations. FT does not provide superpowers or magical thinking. It helps remove the irrational fear so that the client can comfortably engage in everyday activities. Below is a case example of my use of FT with a client who had been mugged.
Della, a 33-year-old Caucasian female, was mugged seven years ago on the street. Since then, she had been unable to walk alone at night. She always had to have someone walk her places after dark, or she avoided going out altogether. Della lived in a safe suburb and did not have an urgent need to go anywhere at night. She stated, “I want to be able to walk alone at night if I need to.” Recently, Della’s company offered to relocate her to Paris. She was excited about the opportunity but realized that she needed to work on this fear if she was going to move to a big city.
We discussed the mugging in more detail. The incident happened when she was in college. She was studying late at the library and drove home to her apartment at around 2 a.m. She had parked her car in a garage a block away from her apartment. As she was walking home, three people came up behind her, kicked her to the ground, grabbed her backpack containing a laptop, and drove away. When asked to rank the disturbance associated with this memory, Della stated it was a 9 on the SUD scale. For FT, we chose Paris as her PEF. “I’m excited to move there,” Della said. After five sets of FT which took about 10 minutes, Della ranked the SUD at 1 before the session ended.
Two weeks later, Della reported that she had chosen a safe area in her suburb as a test for an evening walk. She walked alone at around 8 p.m. Della stated, “This is something I haven’t been able to do since the mugging seven years ago.” She said that it felt good to walk around and look at the lights. “This time, I didn’t have any physical symptoms,” said Della. She described that she did feel a little nervous, ranking the SUD at 1-2. However, it felt like a normal amount of anxiety compared to the paralyzing fear she had experienced previously. She felt good about the outcome. “I wanted to be able to walk alone at night if I had to, and now I can do that,” Della remarked.
***
In addition to the previous case, I have successfully used FT with other clients, focusing on a variety of negative memories and fears. Some examples include a parent’s suicide, childhood bullying, extreme fear of bugs, chronic pain with fear of becoming disabled, fear of contracting COVID-19, sexual assault, car accident/fear of driving, and near drowning/fear of swimming. In some cases, the problem resolved after only 15 minutes of FT, with no resurgence. In other cases, FT provided some benefit, but additional EMDR work was required to fully re-process the event and maintain results over time. To date, I haven’t observed any negative experiences with FT. Most clients have found FT to be helpful and enjoyable. I should note that FT, like any therapeutic intervention, may not be effective for every client or situation. Clients should be aware of potential risks and limitations of FT before starting therapeutic treatment.
Useful Articles Related to the Flash Technique:
EMDR and The Flash Technique: A Match Made in Heaven?
Helping Adults and Children to Recover from Trauma with a Gentle Flash
Manfield, P., Lovett, J., Engel, L., & Manfield, D. (2017). Use of the flash technique in EMDR therapy: Four case examples. Journal of EMDR Practice and Research, 11(4), 195–205.
File under: The Art of Psychotherapy