EMDR and The Flash Technique: A match made in heaven?
Many of us will recognise the difficulty of working with clients who are at the ‘top end’ of their window of tolerance and the question of ‘how much stabilisation is required’ is foremost, especially when working online. The Flash technique offers a novel and transformative solution to this problem and allows the processing of intense trauma memories to be started in a safe way, early on in therapy. Although the evidence base is still limited in terms of published RCTs, many thousands of EMDR therapists across the world have now been trained in Flash, and continue to report good results. It is important to note that the Flash technique is not a replacement for EMDR but an intervention that can usefully be integrated into the 8-Phase comprehensive psychotherapy approach we know and love as EMDR.
Although simple to learn, the Flash technique must be used precisely, especially with the most severe traumas. There has been considerable innovation since the seminal article in EMDR Journal of Practice and Research in 2017; the need to ‘flash to the trauma memory as quickly as possible without feeling any pain’ has proven unnecessary. The protocol now is simpler and safer, and only involves triple blinks. The other major innovation is the ‘conversational positive engaging focus (PEF)’ – rather than getting a client to think about a positive memory, we just engage them in conversation during the blinking, and this can be about anything, such as favourite TV programmes.
Flash is not a replacement for EMDR
I use Flash in three ways as part of the Standard Protocol (SP). The first is as part of Preparation Phase, where I want to reduce the impact of trauma, whether it be one or multiple events. I am not looking to get SUDs to zero, but to see some reduction in the most significant traumas that have come up during history taking. If there are events that cannot even be mentioned in history taking without causing distress, I would certainly target these. Flash is flexible; it can be ‘blind to therapist’ and moreover can target time periods, for example ‘all the abuse that happened between ages of 8-12’. Once the SUDs are reduced, this ‘folder of targets’ can then be unpacked and more targets worked on with Flash. Multiple incidents can also be targeted simultaneously with Flash, though I tend not to do this for the most intense memories (i.e. SUD=10). Working ‘blind to therapist’ makes early intervention very safe, and puts the client at ease right from the start. Not only do they not need to talk about trauma, they don’t need to feel associated distress either. For some client groups, such as military veterans and those who have experienced childhood sexual abuse, these are the very reasons they are fearful of engaging with therapy. It goes without saying that we don’t call it ‘Flash’ or use the word ‘flash’ for either of these populations.
The second way I use Flash is when working on a specific target during the main part of the work where I ask the client ‘if you were to think about the target, would you find it overly distressing?’ If they say yes, I start with Flash. Once SUDs have fallen, perhaps to less than 5, I switch to the SP. I find that the associative benefits of EMDR come to the fore at this point. Sometimes Flash takes the SUDs down to a zero, in which case I would return to target and to see if there are any other channels of association to be processed (probably with EMDR) before progressing onto Positive Cognition and Body Scan in the usual way.
The third way I use Flash is if I have started with the EMDR Phase 4 processing and it starts getting too intense. I would then ‘back out’ of the target and, pointing to one side, say ‘let’s put that over there’, then have a chat about something interesting whilst we do the triple blinks. Once the intensity is down, we can return to the SP.
I believe that Flash makes EMDR safer and allows processing to proceed quicker with less stabilisation. I would welcome more outcome research to justify the use of Flash as it has transformed my EMDR practice, especially online, making therapy safer, faster and more enjoyable for both parties.
Dr Justin Havens is an EMDR Consultant. He Chairs the EMDR UK’s Communications Committee and has facilitated Dr Manfield’s Flash Training Courses in the UK. For more information about the Flash technique, please email Justin at firstname.lastname@example.org