The recently developed Flash technique enables a therapy client to rapidly and (nearly) painlessly reduce the distress level of an upsetting memory. Pending further research, Flash appears to represent an advance in trauma therapy, in that a) a client who might not otherwise have been able to face a distressing memory will be able to face it and work it through, and b) time to completion of processing is reduced.
Briefly, Flash is done by guiding the client to concentrate on a safe place or other feel-good image, then “flash” past the traumatic memory so rapidly as to be unsure as to whether or not it was viewed, and then back to the feel-good image. In the original version (Manfield, Lovett, Engel, & Manfield, 2017) this is done during slow eye movements, in conjunction with EMDR. When the therapist is using PC, the visualization sequence is done while the therapist counts aloud from one to 10 (Greenwald, 2017).
Memory reconsolidation requires that a mental model is activated, and then exposed to conflicting or disconfirming information.
Flash does not provide sufficient engagement with the memory to allow for conflicting or disconfirming information regarding the negative cognition (e.g., I’m bad, I’m not safe, I have no value, etc.) that drives the memory-related distress.
On the other hand, Flash does provide sufficient engagement with the memory to allow for conflicting or disconfirming information about facing the memory. That is, the belief, “I will not be able to tolerate facing this memory,” is repeatedly disconfirmed by repetitions of Flash.
Ecker proposes that this fear of the memory is the focus of Flash’s memory reconsolidation, and accounts for Flash’s benefit or treatment effect. Ecker further proposes that this explains Flash’s variable end point, at which no further progress is made. For example, if the SUDS (0-10 distress rating) goes from 10 down to 0, that means that the memory content was not the problem; the fear regarding the memory was the problem, which has been resolved. On the other hand, if the SUDS goes from 10 down to 7, that means that after the fear of facing the memory has been resolved, the content of the memory itself still has that much left to work through.
Ecker’s rationale is, in my opinion, overstated on three counts.
1. Ecker stated that Flash is only used for high-SUDS memories that the client is afraid of facing. However, this is not accurate. While Flash is used for such memories, it is also used for high-SUDS memories that the client is willing to face, but might prefer to get through more quickly.
2. Ecker argued that Manfield’s hypothesis that the traumatic memory itself was being processed could not be correct, because cognitions are not explicitly addressed in the Flash technique, and cognitions are the primary basis for memory-associated distress. However:
Cognitions are not the only basis for memory-related distress. Sometimes intense emotions, such as grief, remain with a memory, not because of an inappropriate belief, but because the emotion has not yet been worked through.
Cognitions do not have to be explicitly addressed by a treatment method in order to be impacted. For example, PC does not explicitly address cognitions, yet clients routinely report changes in cognitions, similar to those reported in EMDR, associated with the memory they have worked through.
Many people who experience a Flash session report changes in cognitions regarding the content of the memory, similar to changes reported in a PC or EMDR session.
3. Manfield et al (2017) reported finding that Flash works best when so-called source or feeder memories are not present. For example, Flash will work well on the memory of a single/discrete incident of childhood victimization, but may not work well on the same memory if that incident occurred after a number of other similar incidents. This finding implicates a mechanism of effect that is more relevant to the memory content than to fear of facing the memory.
I do not mean to suggest that Ecker’s hypothesis is wrong. To the contrary, I suspect that he has identified an important element or aspect of Flash’s effectiveness. I also think there’s more to it, consistent with Manfield’s hypothesis that Flash impacts the memory’s content as well.
References
Greenwald, R. (2017). PC Flash script. Unpublished manuscript: Author.
This is a fabulous technique and great addition to the trauma-therapist tool kit. My observations so far are that the positive resource installation is a very important element and there is mastery gained from practicing the mental control of screening out the traumatic memory to focus on the positive image, as well as contamination of the traumatic memory from the positive memory. I also think there is a bit of hypnotic suggestion at work here. I look forward to hearing more about how this technique is helping both therapists and clients in their work.
Regarding two aspects of point 1 just above: “Ecker stated that Flash is only used for high-SUDS memories that the client is afraid of facing” I want to point out that both the video and transcript state that the Flash Technique also is effective for less severe SUDs Levels. And with respect to “it is also used for high-SUDS memories that the client is willing to face, but might prefer to get through more quickly” I offer this: ‘Willingness to face’ the memory is a conscious attitude, but the non-conscious attitude of the client’s emotional brain (limbic system) can even then be unwilling to allow any direct contact with the memory due to expecting to be overwhelmed and agonized by it. The conscious attitude is by no means an indicator of what the implicit, non-conscious model of the situation is. High SUDs with conscious willingness to face the memory is therefore not at odds with Ecker’s analysis.
This is a fabulous technique and great addition to the trauma-therapist tool kit. My observations so far are that the positive resource installation is a very important element and there is mastery gained from practicing the mental control of screening out the traumatic memory to focus on the positive image, as well as contamination of the traumatic memory from the positive memory. I also think there is a bit of hypnotic suggestion at work here. I look forward to hearing more about how this technique is helping both therapists and clients in their work.
Ricky Greenwald also argued that it goes against my analysis of Flash Technique (proposing that it acts only upon a client’s fear of the traumatic memory, not upon the memory itself) that “Many people who experience a Flash session report changes in cognitions regarding the content of the memory, similar to changes reported in a PC or EMDR session.”
However, the mechanism I’ve proposed can result in those observed changes in memory content, in the following way.
As soon as a client’s fear of the memory is greatly dispelled by Flash Technique, the suppression of memory content can be weakened to such a degree (in some cases) that memory content immediately begins coming into awareness or near-awareness enough for mismatch detection (re-appraisal in relation to other, contradictory knowledge possessed by the client) to occur. Such mismatches can disconfirm and dissolve specific beliefs, meanings, or models that had been elements of the memory, through the memory reconsolidation process (without any facilitation of that process by the therapist). The resulting change in memory content is a by-product effect of Flash Technique having dispelled the client’s fear of the memory, and could occur without Flash Technique accessing or acting directly upon the memory at all.
The mechanism described in the previous paragraph has a testable implication: The greater the reduction of clients’ SUDs level, the more numerous, clear and decisive ought to be clients’ reports of change in specific beliefs, meanings, and models that had been elements of the memory.
As Ricky Greenwald noted, the presence of a feeder memory is found to correlate with a reduced effectiveness of Flash Technique, and he stated (in his item #3 rebutting my analysis) that “This finding implicates a mechanism of effect that is more relevant to the memory content than to fear of facing the memory.”
However, the Flash mechanism I’ve proposed, involving fear of facing the memory, can account for this observation, as follows.
Let’s consider the case where there is not only intense fear of being harmed by contacting the traumatic memory being addressed, but also a feeder memory and an intense, non-conscious, fearful expectation of being harmed by any contact with it as well. In such a case, because the two memories are strongly linked, it is reasonable to assume that the client’s high SUDs level is generated by both fears. Flash, according to my analysis, dispels the fear of the traumatic memory being addressed, but that would not also dispel the fear of the feeder memory, so the portion of the SUDs level due to fear of the feeder memory would be unaffected by Flash Technique. Thus the client’s SUDs level decreases only to the level that is due to the feeder memory. In contrast, when there is no feeder memory, the SUDs level can decrease more, even to 0 in some cases.
In that way, the analysis of Flash Technique as acting only upon the fear of the memory can account for the observation that lower effectiveness (less reduction of SUDs level) correlates with the presence of a feeder memory.
That’s a good point. Furthermore, the mechanism you proposed can account for this observation regardless of whether or not the client has a fear of facing the source/feeder memory. Or at least, Flash’s reduced effectiveness in the presence of source/feeder memories is not, as I had suggested, a reason to disconfirm your hypothesis.
Ricky Greenwald also argued that it goes against my analysis of Flash Technique (proposing that it acts only upon a client’s fear of the traumatic memory, not upon the memory itself) that “Many people who experience a Flash session report changes in cognitions regarding the content of the memory, similar to changes reported in a PC or EMDR session.”
However, the mechanism I’ve proposed can result in those observed changes in memory content, in the following way.
As soon as a client’s fear of the memory is greatly dispelled by Flash Technique, the suppression of memory content can be weakened to such a degree (in some cases) that memory content immediately begins coming into awareness or near-awareness enough for mismatch detection (re-appraisal in relation to other, contradictory knowledge possessed by the client) to occur. Such mismatches can disconfirm and dissolve specific beliefs, meanings, or models that had been elements of the memory, through the memory reconsolidation process (without any facilitation of that process by the therapist). The resulting change in memory content is a by-product effect of Flash Technique having dispelled the client’s fear of the memory, and could occur without Flash Technique accessing or acting directly upon the memory at all.
The mechanism described in the previous paragraph has a testable implication: The greater the reduction of clients’ SUDs level, the more numerous, clear and decisive ought to be clients’ reports of change in specific beliefs, meanings, and models that had been elements of the memory.
This argument highlights the value of your proposed mechanism of effect: that once the client is no longer afraid of facing the memory, other good things can happen, because the client may face and interact with the memory. However, you and Manfield (and I) seem to agree that those other good things rely on memory reconsolidation occurring within the content of the memory itself. And that is a different mechanism of effect — and in particular, a different location of effect — than the one you initially proposed.
Ricky, I’m replying here to your last two sentences above.
My proposed analysis asserts only that Flash Technique does not act DIRECTLY on the traumatic memory contents, and that what it acts upon DIRECTLY (the actual target of the technique) is the fearful expectation that any opening of awareness to the traumatic memory would be permanently agonizing and disabling. My subsequently pointing out (in comments above) an INDIRECT effect on memory contents that occurs after the direct effects is fully consistent with what I initially proposed.
And just to be clear: The direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.
In this series of comments and replies, we have considered various extra phenomena and complexities that may or may not occur in a given case of Flash Technique: the presence of a feeder memory, markers of change in the traumatic memory’s negative cognitions, and de-suppressed memory contents coming into awareness and triggering mismatch experiences. However, for the purpose of laying bare the mechanism of Flash Technique with optimal clarity, it’s best to consider first the case in which those extra complications are absent. That most basic case is what is addressed in my mini-webinar video, and the analysis given there should be understood in that context. (For example, where I stated in the mini-webinar video, “that implies that the big reduction of emotional distress produced by Flash Technique is not due to any change induced in the traumatic memory itself,” that was regarding the basic case, where the client indicates a significantly reduced SUDs level but no changes in memory content, and no feeder memory is involved.)
The extra phenomena can then be best analyzed and understood as variations and elaborations of the basic case, and I’m delighted that our discussion here in this blog seems to have made some progress in that direction.
Bruce, you wrote, “[Flash’s] direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.”
I agree that these are discrete instances of memory reconsolidation as the likely mechanism of effect in reducing the memory-associated distress. I don’t necessarily agree that nullifying the fear of the memory is the only “direct” effect of Flash. It may well be the first effect, in cases in which fear of facing the memory is present. However, I don’t see any basis to presume that the content-focused memory reconsolidation that may occur is a less “direct” effect of Flash, or less frequent or less important. The relative presence and importance of each focus may vary memory by memory. Or one or the other focus may indeed be more primary or typical. I think this can only be further clarified by researching it.
Bruce, you wrote, “[Flash’s] direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.”
I agree that these are discrete instances of memory reconsolidation as the likely mechanism of effect in reducing the memory-associated distress. I don’t necessarily agree that nullifying the fear of the memory is the only “direct” effect of Flash. It may well be the first effect, in cases in which fear of facing the memory is present. However, I don’t see any basis to presume that the content-focused memory reconsolidation that may occur is a less “direct” effect of Flash, or less frequent or less important. The relative presence and importance of each focus may vary memory by memory. Or one or the other focus may indeed be more primary or typical. I think this can only be further clarified by researching it.
I have not seen this level of excitement and enquiry in the world of EMDR for many years. I’ve been doing Flash as an exercise in trainings in recent months. Of 130 people so far, doing Flash for the first time with a training partner, we have 127/130 report a desensitising effect and 123/130 report a distancing effect (less vivid, harder to recall, et cetera) . “Clients” focused on a private memory that was not disclosed to their “therapist”.
In the last Advanced two trainings I’ve tried a variation. Rather than Flashing from the base of a positive/pleasurable experience as in Manfield’s version, I’ve had people initially develop a Positive Belief with regard to their target memory, and then explore experiences that fit with that PB, connecting with the sensory and affective elements of that memory. This provides a better juxtaposition experience than standard Flash.
Not only are we still seeing the same distancing and desensitising effects as standard Flash, but most people also report significant cognitive shifts, towards a VoC of 6 or 7.
Some of my trainees have given me feedback about trying this with clients, and whilst the numbers are small at this stage, or the results have been positive. In other words we getting the same processing effects we see with EMDR – distancing, desensitisation and adaptive cognitive shifts – without actually doing EMDR.
Very interesting. In the PC version of Flash, we start with the beginning of the story (well before the bad part) and end with the ending of the story (well after any bad part). This also provides a memory-specific contrast to the memory, similar to the positive cognition sandwich. Though different as well. I’ve also tried it (with counting, which is the PC version) with an unrelated feel-good image to start and end, but the memory-related beginning and ending work better. These findings are consistent with the memory reconsolidation account in that the beginnings and endings, as well as the positive cognition sandwich, structure in disconfirmation of at least one negative aspect of the memory.
Ricky, I’m replying here to your last two sentences above.
My proposed analysis asserts only that Flash Technique does not act DIRECTLY on the traumatic memory contents, and that what it acts upon DIRECTLY (the actual target of the technique) is the fearful expectation that any opening of awareness to the traumatic memory would be permanently agonizing and disabling. My subsequently pointing out (in comments above) an INDIRECT effect on memory contents that occurs after the direct effects is fully consistent with what I initially proposed.
And just to be clear: The direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.
In this series of comments and replies, we have considered various extra phenomena and complexities that may or may not occur in a given case of Flash Technique: the presence of a feeder memory, markers of change in the traumatic memory’s negative cognitions, and de-suppressed memory contents coming into awareness and triggering mismatch experiences. However, for the purpose of laying bare the mechanism of Flash Technique with optimal clarity, it’s best to consider first the case in which those extra complications are absent. That most basic case is what is addressed in my mini-webinar video, and the analysis given there should be understood in that context. (For example, where I stated in the mini-webinar video, “that implies that the big reduction of emotional distress produced by Flash Technique is not due to any change induced in the traumatic memory itself,” that was regarding the basic case, where the client indicates a significantly reduced SUDs level but no changes in memory content, and no feeder memory is involved.)
The extra phenomena can then be best analyzed and understood as variations and elaborations of the basic case, and I’m delighted that our discussion here in this blog seems to have made some progress in that direction.
I have not seen this level of excitement and enquiry in the world of EMDR for many years. I’ve been doing Flash as an exercise in trainings in recent months. Of 130 people so far, doing Flash for the first time with a training partner, we have 127/130 report a desensitising effect and 123/130 report a distancing effect (less vivid, harder to recall, et cetera) . “Clients” focused on a private memory that was not disclosed to their “therapist”.
In the last Advanced two trainings I’ve tried a variation. Rather than Flashing from the base of a positive/pleasurable experience as in Manfield’s version, I’ve had people initially develop a Positive Belief with regard to their target memory, and then explore experiences that fit with that PB, connecting with the sensory and affective elements of that memory. This provides a better juxtaposition experience than standard Flash.
Not only are we still seeing the same distancing and desensitising effects as standard Flash, but most people also report significant cognitive shifts, towards a VoC of 6 or 7.
Some of my trainees have given me feedback about trying this with clients, and whilst the numbers are small at this stage, or the results have been positive. In other words we getting the same processing effects we see with EMDR – distancing, desensitisation and adaptive cognitive shifts – without actually doing EMDR.
Having read the various comments in this blog, I thought I’d weigh in with some additional data.
It is not uncommon that a client begins receiving flash technique without any expectation of what is supposed to happen. Clients are told that they should not think about or bring to mind the disturbing memory. They are also cautioned not to try to evaluate whether this process is accomplishing anything, because to do that they would need to think of the memory, and we don’t want them to do that. For some, not all clients, after five triple flashes (less than five minutes), they are asked if they notice any change in the memory. In some cases, the dialog might go like this: “I know I told you not to think of the memory. Were you able to do that?” ”Yes” “Well, now, I’d like you to actually think of it, and notice if there is any change at all.” “Well, yes, something has changed.” “What is it?” “Well, it’s not disturbing anymore,” or “I can hardly bring it up,” or “The emotions seem separated from the memory.”
These complete five minute resolutions are not uncommon. At each of the webinars we have been producing every two months, we typically have done five live demonstrations of approximately five minutes each. Some of them play out very much like this. One woman wrote in the chat section about thirty minutes after being a demonstration client, “I’ve been working on that issue for seven years, and I can’t believe it’s not upsetting anymore.”
For the purposes of this discussion, the important feature of this interaction is that the client has not evaluated his or her progress, and so has noticed no change. There is no expectation error until they realize that the memory is no longer disturbing. Typically, for these clients, adaptive adult perspectives (cognitions) spontaneously arise. Sometimes, the clients appear dumbfounded and say, “What happened?” From the point of view of memory reconsolidation, this phenomenon is hard to explain. In my view, the processing occurred at this accelerated rate because conscious defenses were not engaged. Also, the client was prevented from reliving the memory, and observing from the present adult perspective becomes clear that it is in the past and over.
An interesting article that is worth considering is “Towards an Unconscious Neurotherapy for Common Fears” (Vincent Taschereau-Dumouchel Vincent, et.al, 2017) These researchers used FMRI to identify locations in the brain that tended to store typical phobia reactions, like snakes and spider. They were able to stimulate those parts of the brain while having subjects think of other things. The subjects chosen had both spider and snake phobias, and only one was processed. The client did not know which one was being processed and, like with flash, had NO experience of the fear. Yet, significant easing of the target fear was accomplished without any effect on the non-targetted fear. This study and a few others lend credence to the claim that trauma can be processed without the client consciously accessing the memory.
Full citation: Taschereau-Dumouchel, Aurelio Cortese, Toshinori Chiba, J. D. Knotts, Mitsuo Kawato, Hakwan Lau, , July 30, 2017 (This article has not been peer reviewed)
Having read the various comments in this blog, I thought I’d weigh in with some additional data.
It is not uncommon that a client begins receiving flash technique without any expectation of what is supposed to happen. Clients are told that they should not think about or bring to mind the disturbing memory. They are also cautioned not to try to evaluate whether this process is accomplishing anything, because to do that they would need to think of the memory, and we don’t want them to do that. For some, not all clients, after five triple flashes (less than five minutes), they are asked if they notice any change in the memory. In some cases, the dialog might go like this: “I know I told you not to think of the memory. Were you able to do that?” ”Yes” “Well, now, I’d like you to actually think of it, and notice if there is any change at all.” “Well, yes, something has changed.” “What is it?” “Well, it’s not disturbing anymore,” or “I can hardly bring it up,” or “The emotions seem separated from the memory.”
These complete five minute resolutions are not uncommon. At each of the webinars we have been producing every two months, we typically have done five live demonstrations of approximately five minutes each. Some of them play out very much like this. One woman wrote in the chat section about thirty minutes after being a demonstration client, “I’ve been working on that issue for seven years, and I can’t believe it’s not upsetting anymore.”
For the purposes of this discussion, the important feature of this interaction is that the client has not evaluated his or her progress, and so has noticed no change. There is no expectation error until they realize that the memory is no longer disturbing. Typically, for these clients, adaptive adult perspectives (cognitions) spontaneously arise. Sometimes, the clients appear dumbfounded and say, “What happened?” From the point of view of memory reconsolidation, this phenomenon is hard to explain. In my view, the processing occurred at this accelerated rate because conscious defenses were not engaged. Also, the client was prevented from reliving the memory, and observing from the present adult perspective becomes clear that it is in the past and over.
An interesting article that is worth considering is “Towards an Unconscious Neurotherapy for Common Fears” (Vincent Taschereau-Dumouchel Vincent, et.al, 2017) These researchers used FMRI to identify locations in the brain that tended to store typical phobia reactions, like snakes and spider. They were able to stimulate those parts of the brain while having subjects think of other things. The subjects chosen had both spider and snake phobias, and only one was processed. The client did not know which one was being processed and, like with flash, had NO experience of the fear. Yet, significant easing of the target fear was accomplished without any effect on the non-targetted fear. This study and a few others lend credence to the claim that trauma can be processed without the client consciously accessing the memory.
Full citation: Taschereau-Dumouchel, Aurelio Cortese, Toshinori Chiba, J. D. Knotts, Mitsuo Kawato, Hakwan Lau, , July 30, 2017 (This article has not been peer reviewed)
Phil, thanks for weighing in here. It sounds like you’re moving away from the memory reconsolidation account towards something else. But couldn’t memory reconsolidation still be occurring even if not at the conscious level? It also sounds like the Flash technique is continuing to evolve, and you now do an even more avoid-the-memory version than what was described in your article. And others such as Graham Taylor and I are experimenting with different types of bread for the sandwich, so to speak. The introduction of Flash, along with further innovations, research, and discussions like these, will likely lead to a better understanding of how trauma healing works.
I think these discussions and innovation in the field are outstanding and right at the cutting edge of trauma therapy. It is also edifying that this is happening in a spirit of cooperation that is not always present in our profession.
I do agree with Phil, and have experimented myself with getting the briefest and smallest possible ‘exposure’ to the memory as possible, which makes Flash safer and more usable by a wider audience. Until I listened to Phil’s webinar, I didn’t realise the degree to which this is possible – ie clients wondering whether they have actually ‘flashed’ to the trauma at all for example. My own experiment recently was to use the metaphor of a piece of paper on the table, with the trauma on the underside of it completely out of view. The instruction ‘go flash’ was for clients to briefly glance at the paper (not the underside) and then reconnection with engaging place. For me, this seemed to minimise ‘sliding into’ any trauma memory.
Preventing clients dropping into, or dissociating out of severe trauma is really important, and the more the protocol can safeguard against this the better.
Long may this work continue, and evolve as the finest trauma interventions ever seen!
I have just listened to Bruce’s full youtube commentary, which is very interesting. My only observation is that I have used Flash with memories that don’t fall into the ‘if I look at this memory, I will be overwhelmed’etc. category, and it works perfectly well. ie memories that don’t have ‘lethal status’.
Therefore, I think Bruce might be overreaching himself in his hypothesis and the distinction between ‘fear of the memory’ and the memory itself.
So, I think Flash is processing the traumatic memory – the full mechanism, and also the degree to which this is achieved in practice, needs further research. I think the feeder memory theory holds some truth.
For a client where Flash didn’t work, moving into standard EMDR processing also didn’t work until the feeder memory was located and processed
I think these discussions and innovation in the field are outstanding and right at the cutting edge of trauma therapy. It is also edifying that this is happening in a spirit of cooperation that is not always present in our profession.
I do agree with Phil, and have experimented myself with getting the briefest and smallest possible ‘exposure’ to the memory as possible, which makes Flash safer and more usable by a wider audience. Until I listened to Phil’s webinar, I didn’t realise the degree to which this is possible – ie clients wondering whether they have actually ‘flashed’ to the trauma at all for example. My own experiment recently was to use the metaphor of a piece of paper on the table, with the trauma on the underside of it completely out of view. The instruction ‘go flash’ was for clients to briefly glance at the paper (not the underside) and then reconnection with engaging place. For me, this seemed to minimise ‘sliding into’ any trauma memory.
Preventing clients dropping into, or dissociating out of severe trauma is really important, and the more the protocol can safeguard against this the better.
Long may this work continue, and evolve as the finest trauma interventions ever seen!
I have just listened to Bruce’s full youtube commentary, which is very interesting. My only observation is that I have used Flash with memories that don’t fall into the ‘if I look at this memory, I will be overwhelmed’etc. category, and it works perfectly well. ie memories that don’t have ‘lethal status’.
Therefore, I think Bruce might be overreaching himself in his hypothesis and the distinction between ‘fear of the memory’ and the memory itself.
So, I think Flash is processing the traumatic memory – the full mechanism, and also the degree to which this is achieved in practice, needs further research. I think the feeder memory theory holds some truth.
For a client where Flash didn’t work, moving into standard EMDR processing also didn’t work until the feeder memory was located and processed.
What a rich, interesting, and enjoyably collegial exploration this is. In response to the more recently added comments, I’ll add these thoughts:
Some of the comments above seem to assume that if a client initially does not consciously feel fear of experiencing the target traumatic memory, it means there is no significant fear of the memory (and then the Flash mechanism I’ve proposed wouldn’t be relevant). But, of course, there is much more happening than a client is consciously aware of, as a rule. It is commonplace in therapy for it to emerge that the client has a major fear (or other emotion) that has been completely outside of awareness.
For example, I once had a client who had a whole array of diverse compulsive behaviors he wanted to shed. We found that every one of those behaviors was a way to avoid a situation or activity that would bring a heightened sense of aloneness, which was urgent to avoid because it would feel like he was sliding back into the terrifying and desolate aloneness he suffered throughout childhood. Before therapy he had no conscious awareness that he was terrified of aloneness, though that fear was ruling his life. His many avoidance and self-distraction tactics had been doing their job well, so he rarely felt aloneness and never noticed his great fear of it.
My point is that clients’ reports of what they consciously feel or don’t feel is hardly a complete account of their psychological process, and if we think it is, we are likely to arrive at false conclusions.
Furthermore, here in this discussion of Flash Technique we’re dealing with unprocessed *traumatic* memory. By definition, a traumatic memory contains an ordeal, an agonizing, intensely frightening experience. So, it seems extremely unlikely that a client could have little or no disowned, suppressed fear of bringing the memory of such an experience into direct awareness and affective re-experiencing. Fear of the memory could be intense and yet be entirely outside of awareness. Non-conscious fear is just as effective at blocking access to the memory as conscious fear is.
Such fear of the memory is based in the expectation that experiencing the memory would bring intense, prolonged suffering. That expectation is what my analysis of Flash Technique proposes is the actual direct target of the technique. With that expectation disconfirmed and dissolved via memory reconsolidation, the memory is now safe for accessing, so accessing is now allowed by the emotional brain systems. It’s at this point, with the memory unblocked and readily accessible, that the contents of the memory could juxtapose with adaptive adult knowings and be disconfirmed and dissolved. I view that as a by-product effect of Flash Technique, not its direct action, though of course it’s the most important effect of all.
Phil Manfield wrote above, “Typically, for these clients, adaptive adult perspectives (cognitions) spontaneously arise.” But what causes this spontaneous arising? They arise, I suggest, because the now unblocked memory has automatically been subjected to mismatch detection, and adult knowings that don’t match what’s in the memory get activated and pop forward into awareness. That is how the “expectation error” (and memory reconsolidation) would be occurring here, and it can occur in the background, without having the client’s attention (so I agree with Ricky’s comment, “couldn’t memory reconsolidation still be occurring even if not at the conscious level?”). This explanation predicts that the adult knowings that arise spontaneously are always ones that contradict some part of the traumatic memory schema. They arise *because* they contradict the memory.
Bottom line: Everything Phil describes can be accounted for in terms of memory reconsolidation, with no unexplained gaps. That doesn’t prove anything, but it’s important to recognize that we have a candidate model that is consistent and complete.
First, I would like to express my gratitude to Dr. Manfield for describing and sharing his unique and intriguing approach to facilitated treatment of trauma patients. I would also like to thank Dr. Greenwald for providing this forum for informed discussion.
I would like to provide an alternative perspective in this enlightened discussion of the Flash Technique. Let’s bear in mind that this is a complex topic that is clearly unsettled, despite various spirited assertions of a definitive explanation that conforms to a pre-existing paradigm. I offer an alternative postulation of the principles underlying the effectiveness of the Flash Technique, as well as a different perspective on the memory reconsolidation process itself.
I prefer to look at things from an evolutionary psychology perspective, which I think is particularly applicable and valid in this setting. The ability to achieve memory reconsolidation, as well as revision is hard-wired, suggesting an evolutionary survival benefit to this process. We know from rat studies as well as human brain imaging that the amygdala (fight or flight center) is intimately involved in traumatic memory “intake” and retrieval, further supporting the hypothesized evolutionary survival benefit. I subscribe to the hypothesis that traumatic memories remain “unprocessed” in the brain, allowing the organism to maintain ongoing access to the information and thereby avoid further pain similar to the index event, facilitating an evolutionary survival benefit..
A proposed explanation for the evolutionary advantage of memory reconsolidation is to reinforce and “strengthen” the threatening memory, assisting the organism in avoiding pain and consequently promoting survival. Immediate access to “comparative” information from the prior perceived threat can be immediately utilized to assist survival in the face of a perceived similar threat situation. This hypothesis also provides a rational explanation for the “triggers” present in trauma sufferers. Similarly, the evolutionary justification for hypervigilance and thought intrusion is evident.
The process of memory reconsolidation interference and revision is proposed to be an adaptive mechanism that allows the existing fear based memory to be updated, and thereby incorporate new information which may be disconfirming to the preexisting working schema supported by the specific memory. This process would be evolutionarily beneficial to the species by allowing the organism to adapt and better survive in changing environmental conditions. In rats, the required expectancy violation appears to have a narrow degree of allowance to provide the acceptable conditions that allow for memory reconsolidation interference and reconsolidation. The applicability of this finding in rats to the process in humans is uncertain at this time. The much more complex human interactions, perceptions, and attributed meanings would logically be expected to introduce a multitude of variables, and exponentially complicate our assessment of conditions necessary to provide an expectancy violation. Although there are several theories regarding the expectancy violation requirements in humans, this complex issue is understandably not well defined or understood at present. It appears to encompass much more complexity than an overt juxtaposition and cognitive realization of an emotional learning mismatch, although this certainly can be profoundly effective if realized experientially. I believe that the dissolution of negative cognitions and replacement with positive cognitions can often be explained as a result of, rather than a cause of expectancy violation. (Further discussed below.) It seems apparent that whatever the target, the predictive error must be experientially realized by the individual to be effective.
If you accept this explanation, then the rational justification for fear of traumatic memory content recall becomes almost self-evident. The inner mind (subconscious) maintains the memory in an “activated state”, believing that the event is still occurring, (on a subconscious level, outside of the realm of conscious realization.) A person’s conscious fear of direct recall of the content can be explained on the basis of a fear of “reliving” the event, recreating an overwhelming perceived threat to survival. So, although the inner mind is continuously trying to keep the memory active and alive to protect the organism, the conscious mind is vigorously trying to defend itself against the perceived threat to survival. Thus the resultant inner struggle and suffering associated with PTSD subjects as well as other trauma victims.
Therapeutic assistance in creating some type of predictive error that the brain accepts, which then promotes memory reconsolidation interference and revision can be effectively utilized to “extinguish the ongoing perceived threat assessment”, and thereby “strip” the profoundly upsetting emotional overlay; allowing the brain to fully “process” the memory, and resolve the internal struggle. The basis for this brain “glitch” that creates the distress can be viewed as a direct result of an evolutionarily hard-wired mechanism that has been inappropriately activated secondary to an environmental mismatch (very different from a predictive error).
I believe that this paradigm provides a logical evolutionarily and intellectually based justification for the fear of conscious traumatic memory recall, which can be applied to the understanding of the beneficial effects of the Flash Technique as well as multiple other effective strategic therapies.
The actual predictive error mismatch that Dr. Manfield’s technique presumably effects, to at times achieve a SUDS=0 effect is intriguing to speculate about. (Of course there are multiple variables related to the assumed clinical benefit proposed by that assertion, not the least of which is the duration of relief and the generalization of the result.) Briefly, let’s consider if such a brief recollection could be sufficient to activate the neuronal pathway for reconsolidation. The additional references that he provides in his article, including the above reference regarding subconscious reconsolidation revision suggests that this is indeed possible. There are other described therapeutic interventions (beyond the scope of this discussion) which appear to resolve suffering through a memory reconsolidation interference and revision mechanism, while involving only a limited or cursory activation of the traumatic memory, rather than an extensive and detailed “re-experiencing”. The Flash Technique certainly represents the extreme end of this spectrum.
Regarding the predictive error mismatch, there are multiple techniques that have been demonstrated to be effective in achieving an “effortless and permanent” resolution of suffering related to a prior trauma, but do not fit into the “traditional” memory reconsolidation mismatch paradigm. I would submit that there are multiple complex effective targets of expectancy violation, including emotional mismatch, and “time mismatch”, as postulated by Dr. Manfield in his article describing the Flash Technique. I personally feel that it is logical and rational to believe that the requirements for an individual’s brain to experientially realize” an expectancy error sufficient to invalidate an underlying schema are highly variable and not always easily discernible or classifiable. Utilizing the model whereby a traumatic memory is “unprocessed” and the subconscious mind believes that the trauma is ongoing, the rationale of a “time mismatch” as a prevalent source of effective mismatch can be clearly envisioned.
A partial reduction of the SUD level with the Flash Technique does not support Ecker’s assertion that only the fear of the memory recall itself has been reduced, and therefore the remaining upset must be due to the content of the memory, which has not been addressed. There are multiple reasons for a lack of complete resolution of distress, not the least of which is the absence of an intentioned target of predictive error, resulting in only a “partial disconfirmation” of expectancy. This outcome does not invalidate the existence of an expectancy violation related to the original traumatic memory as an explanation of its underlying mechanistic process. Ecker’s reasoning is an invalid “the exception proves the rule” assertion. Animal studies and empiric data suggest multiple sources of potential reduced or absent efficacy.
Additionally, I would suggest that the “adaptive adult perspectives (cognitions)” that “spontaneously arise”, as stated by Dr. Manfield were most likely a result of an emotional “stripping” of the memory, created by a “non-cognitive” expectancy violation, rather than an integral part of the disconfirmation process itself. I would submit that once the traumatic memory is “processed”, the associated negative cognitions are no longer supported, and thereby “dissolve”, allowing the “spontaneous” emergence of adaptive positive cognitions, just as Dr. Manfield describes. i.e. I am wearing very dark glasses outside, and everything looks dark and gloomy. I then remove the glasses, and I am now able to spontaneously appreciate the bright and colorful nature of the world, as I am no longer constrained by the dark lenses.
So, to summarize, I would assert that the actual target of the predictive error is the memory content itself, and the “fear of recalling a memory” as the target of the predictive error is illogical from an evolutionary psychological perspective. I believe that the above proposed hypothesis is logically coherent with the evolutionary development and hard-wiring of the memory reconsolidation and revision process in the human as well as animal CNS. Furthermore, empirical evidence in humans supports the idea that there are indeed multiple and varied targets of an expectancy violation that can be exploited to achieve memory reconsolidation interference and revision. The requirements for expectancy violation appear to be extremely complex and quite variable from individual to individual, and this remains an area of active research and investigation.
I appreciate the willingness of Drs. Greenwald and Manfield to remain unconstrained by current memory reconsolidation paradigms, thereby maintaining an open-minded perspective; thus promoting the advancement of additional novel, efficient and effective methods that allow us to treat and resolve trauma in those in whom “the past is present”.
Thank you Ricky for hosting this interesting discussion. I would like to introduce one question into this dialogue. While I am very excited to hear about the reported successes of the evolving Flash technique, and I can certainly see its utility in working with people struggling with complex trauma histories, thus allowing folks to process traumas that were previously too extreme to tolerate thinking about, I find myself wondering about your long term goals of treatment. If a client is able to process a traumatic memory without consciously reviewing it are they actually gaining mastery? are they integrating the experience in a manner that leaves them with an internalized roadmap for processing and mastering traumatic experiences on their own, outside of therapy? In my mind processing trauma is not just about reducing the SUD’s to 1 or 0. Rather it includes helping the client recognize that they can go through something terrible, become paralyzed by intolerable helplessness or shame, and then, through treatment, see that their frailty is part of what makes them human, and that they can survive it. They can come out on the other side. This is important because it reduces their feelings of shame and helplessness as they face other challenges and potentially traumatic experiences as they continue to move through their lives. So, my question is, after Flash processing intolerable trauma on an unconscious or partially conscious level would you be content with that just because the SUD’s went down? Or would you eventually come back around and review those traumatic experiences on a more conscious level after they have been desensitized? (incorporating future template, etc), thus adding to the clients growing sense of resilience and mastery, and reducing their vulnerability to shame and helplessness in the future.
I guess this is the old question of whether the goal of treatment is to just return the client to adaptive functioning (some may call this applying a band-aid), or to facilitate growth and resilience so that they are able to witness whatever arises in their lives without remaining embedded and stuck in reactive patterns that perpetuate negative and debilitating belief systems. For me this means going beyond the script of any protocol and providing the client with the experience of being seen, and known, and validated as a human being who can be knocked down by trauma but then get back up with renewed confidence and wisdom.
In either case the work that you all (Phil, Bruce, Ricky, and others) are doing is clearly moving the field of trauma treatment forward in exciting ways. I tip my hat
Bruce I love your question! Here’s my own answer, as far as it goes:
I don’t think what you’ve described is the difference between healing vs. band-aid. You get healing either way. The question is whether the more effortless healing of Flash might deprive the client of the valuable experience of working for/through the healing.
I think this is in part a philosophical question and in part a practical one. If someone can’t otherwise do the trauma work, then starting with Flash makes the rest of it possible. OTOH if the person can do it, is it still OK to do it faster?
Wasn’t that same question posed regarding EMDR, all those years ago? For example: Do you let someone do their normal grief processing over months or years, or in minutes or hours via EMDR?
I’ve generally been in the “go for it” camp, provided that the client wants to do that as well. However, even with EMDR, there is a sense of doing the work, even if quickly. With Flash, the question is raised in a new way. I don’t know the answer.
Thank you Ricky for hosting this interesting discussion. I would like to introduce one question into this dialogue. While I am very excited to hear about the reported successes of the evolving Flash technique, and I can certainly see its utility in working with people struggling with complex trauma histories, thus allowing folks to process traumas that were previously too extreme to tolerate thinking about, I find myself wondering about your long term goals of treatment. If a client is able to process a traumatic memory without consciously reviewing it are they actually gaining mastery? are they integrating the experience in a manner that leaves them with an internalized roadmap for processing and mastering traumatic experiences on their own, outside of therapy? In my mind processing trauma is not just about reducing the SUD’s to 1 or 0. Rather it includes helping the client recognize that they can go through something terrible, become paralyzed by intolerable helplessness or shame, and then, through treatment, see that their frailty is part of what makes them human, and that they can survive it. They can come out on the other side. This is important because it reduces their feelings of shame and helplessness as they face other challenges and potentially traumatic experiences as they continue to move through their lives. So, my question is, after Flash processing intolerable trauma on an unconscious or partially conscious level would you be content with that just because the SUD’s went down? Or would you eventually come back around and review those traumatic experiences on a more conscious level after they have been desensitized? (incorporating future template, etc), thus adding to the clients growing sense of resilience and mastery, and reducing their vulnerability to shame and helplessness in the future.
I guess this is the old question of whether the goal of treatment is to just return the client to adaptive functioning (some may call this applying a band-aid), or to facilitate growth and resilience so that they are able to witness whatever arises in their lives without remaining embedded and stuck in reactive patterns that perpetuate negative and debilitating belief systems. For me this means going beyond the script of any protocol and providing the client with the experience of being seen, and known, and validated as a human being who can be knocked down by trauma but then get back up with renewed confidence and wisdom.
In either case the work that you all (Phil, Bruce, Ricky, and others) are doing is clearly moving the field of trauma treatment forward in exciting ways. I tip my hat.
“ I would assert that the actual target of the predictive error is the memory content itself, and the “fear of recalling a memory” as the target of the predictive error is illogical from an evolutionary psychological perspective.”
I respectfully disagree that the “fear of recalling a memory” isn’t logical, evolutionarily-speaking. What we’re calling “a memory” is actually a terrifying, lived experience. It makes sense to me that we can be both terrified of bad things happening, and terrified of becoming terrified, again. It is quite common that people become afraid of both the contents of their mind, and of thinking or feeling itself. To avoid “bad” and seek “good”, be that thoughts, feelings, or “anticipatory bad”, has evolutionary value, IMO.
Bruce McCarter, I love your question/comment too. IMO, whether we seek to go beyond SUDS reduction really depends upon the patient and their goals. As we all know, some seek only symptom relief, and others seek a deepening awareness of self, other, relationship and a more meaningful life. Furthermore, some seek and find the latter with their therapist, and some seek and find it in other, extra therapy relationships.
Speaking of relationships, I recognize this may seem “old school”, but most so-called trauma memories are, in my patients, about having been hurt in relationship. Whatever flash or any other technique may accomplish, I for one never minimize the power that my patient and I are doing this work together. A therapeutic relationship is, at times, the most powerful mismatch experience of all.
“ I would assert that the actual target of the predictive error is the memory content itself, and the “fear of recalling a memory” as the target of the predictive error is illogical from an evolutionary psychological perspective.”
I respectfully disagree that the “fear of recalling a memory” isn’t logical, evolutionarily-speaking. What we’re calling “a memory” is actually a terrifying, lived experience. It makes sense to me that we can be both terrified of bad things happening, and terrified of becoming terrified, again. It is quite common that people become afraid of both the contents of their mind, and of thinking or feeling itself. To avoid “bad” and seek “good”, be that thoughts, feelings, or “anticipatory bad”, has evolutionary value, IMO.
Bruce McCarter, I love your question/comment too. IMO, whether we seek to go beyond SUDS reduction really depends upon the patient and their goals. As we all know, some seek only symptom relief, and others seek a deepening awareness of self, other, relationship and a more meaningful life. Furthermore, some seek and find the latter with their therapist, and some seek and find it in other, extra therapy relationships.
Speaking of relationships, I recognize this may seem “old school”, but most so-called trauma memories are, in my patients, about having been hurt in relationship. Whatever flash or any other technique may accomplish, I for one never minimize the power that my patient and I are doing this work together. A therapeutic relationship is, at times, the most powerful mismatch experience of all.
I have been reading these comments with interest since I have been actually been receiving Flash EMDR treatment so in some sense I feel I am in a unique experience to describe what is actually happening to me: emotionally, physiologically and existentially. I will keep my comments brief. Though I could probably produced pages of text. I think Dr. Greenwald hits the nail on its head with his last comment. It depends on how you define integration or healing. I prefer Carl Jung’s definition insofar as our human experience is part of an individuation experience. There really is no beginning or end. However, from the practical perspective, both the therapist and the client need to come to some understanding about when the work is done. EMDR and Flash EMDR have helped me deal with intense emotional experiences (including a violent Near Death Experience) — and I am still of the opinion that it is the relational repair or connection to the therapist as well as other healthy individuals in one’s community that is the most essential component. Please know that your client needs to know that they are not alone. Even if you have ‘installed’ the positive emotional state, and your client can go there, your client still needs to feel your presence with ‘eye contact’ or ‘smile’ or the holding of your hand. Stephen Porges, Dan Siegel, Bruce Perry, Peter Levine and many other trauma neuroscientic informed experts makes the same point, but in different ways about the inportance of connection. Polyvagal theory is relevant in this regard. Also, I have experienced the ‘after effects’ of Flash EMDR. It’s not done with reconsolidation after the appointment. The effects linger into the night as I sleep and a couple of days later in my experience. I ‘know’ my brain is still trying to adjust to the Flash EMDR experience. I have had a profound neurophysiological shift occur in my body as a result of all the Flash EMDR sessions in a relatively short span of time. That can be a shock to one’s neurophysiology. As Bessel van der Kolk says, “The Body Keeps the Score”… It’s not just my brain that’s integrating, my body is trying to integrate or make sense of the experience of Flash EMDR. How do I honor what my body needs during any moment is a central consideration. My body contains bodily memories from decades ago – this stuff is not just trauma that has been stuffed in my brain. For example, I had high blood pressure before Flash EMDR. Now my blood pressure is normal I assuming because my parts are no longer stuck in FIGHT response. I have also experienced changes in my digestive system. I believe it’s essential to listen to to what the body needs. Sometimes my body needs to discharge the energy. Sometimes I need to sleep and adjustment needs to be made to diet, exercise and activities as my body continues to adjust and play catch up with the changes in my brain. This takes time. The process of healing is best not rushed. Trust your client. Healing or integration is a lot about timing and pacing while honoring the client who should be encouraged to listen to their own body and listen to their dreams! Dreams are the gateway to the unconscious. They will tell you a lot about where your client needs to go if you listen. I would also like to make the point, while Flash EMDR is an exciting advance, there’s still so much more we don’t know about the brain and memory reconsolidation. How is it possible for my brain to process memories that are outside my level of conscious awareness? Is Flash EMDR a form of hypnosis that simply bypasses the defenses or ‘parts’ so that ‘they’ cannot interfere with the process — because ‘parts’ do emerge and those ‘parts’ need to be honored (in my experience). Otherwise, whatever intervention you are attempting might end up backfiring on you. Dr. Greenwald also poses an interesting question when he talks about grief. Do you let someone grief over months, days, hours or minutes? Well, that’s an ethical question to me since I believe that the therapist is in service for the client. I believe you honor the client by listening to the client and or the parts. Ask the client what they need. That’s what I suppose I appreciate about Internal Family Systems is because there is a recognition that with complex trauma you are working with a dissociative system. As my previous therapist said, “you want to make sure all parts are on board”. I feel so fortunate to have been the recipient of Flash EMDR treatment. Thank you to all of you who have dedicated your lives to help people heal from trauma. Flash EMDR has been a game changer for me. I feel I have been given a new life. I also appreciated Bruce McCarter’s comment: the goal of treatment means “going beyond the script of any protocol and providing the client with the experience of being seen, heard and validated as a human being who can be knocked down by trauma [or near death
I have been reading these comments with interest since I have been actually been receiving Flash EMDR treatment so in some sense I feel I am in a unique experience to describe what is actually happening to me: emotionally, physiologically and existentially. I will keep my comments brief. Though I could probably produced pages of text. I think Dr. Greenwald hits the nail on its head with his last comment. It depends on how you define integration or healing. I prefer Carl Jung’s definition insofar as our human experience is part of an individuation experience. There really is no beginning or end. However, from the practical perspective, both the therapist and the client need to come to some understanding about when the work is done. EMDR and Flash EMDR have helped me deal with intense emotional experiences (including a violent Near Death Experience) — and I am still of the opinion that it is the relational repair or connection to the therapist as well as other healthy individuals in one’s community that is the most essential component. Please know that your client needs to know that they are not alone. Even if you have ‘installed’ the positive emotional state, and your client can go there, your client still needs to feel your presence with ‘eye contact’ or ‘smile’ or the holding of your hand. Stephen Porges, Dan Siegel, Bruce Perry, Peter Levine and many other trauma neuroscientic informed experts makes the same point, but in different ways about the inportance of connection. Polyvagal theory is relevant in this regard. Also, I have experienced the ‘after effects’ of Flash EMDR. It’s not done with reconsolidation after the appointment. The effects linger into the night as I sleep and a couple of days later in my experience. I ‘know’ my brain is still trying to adjust to the Flash EMDR experience. I have had a profound neurophysiological shift occur in my body as a result of all the Flash EMDR sessions in a relatively short span of time. That can be a shock to one’s neurophysiology. As Bessel van der Kolk says, “The Body Keeps the Score”… It’s not just my brain that’s integrating, my body is trying to integrate or make sense of the experience of Flash EMDR. How do I honor what my body needs during any moment is a central consideration. My body contains bodily memories from decades ago – this stuff is not just trauma that has been stuffed in my brain. For example, I had high blood pressure before Flash EMDR. Now my blood pressure is normal I assuming because my parts are no longer stuck in FIGHT response. I have also experienced changes in my digestive system. I believe it’s essential to listen to to what the body needs. Sometimes my body needs to discharge the energy. Sometimes I need to sleep and adjustment needs to be made to diet, exercise and activities as my body continues to adjust and play catch up with the changes in my brain. This takes time. The process of healing is best not rushed. Trust your client. Healing or integration is a lot about timing and pacing while honoring the client who should be encouraged to listen to their own body and listen to their dreams! Dreams are the gateway to the unconscious. They will tell you a lot about where your client needs to go if you listen. I would also like to make the point, while Flash EMDR is an exciting advance, there’s still so much more we don’t know about the brain and memory reconsolidation. How is it possible for my brain to process memories that are outside my level of conscious awareness? Is Flash EMDR a form of hypnosis that simply bypasses the defenses or ‘parts’ so that ‘they’ cannot interfere with the process — because ‘parts’ do emerge and those ‘parts’ need to be honored (in my experience). Otherwise, whatever intervention you are attempting might end up backfiring on you. Dr. Greenwald also poses an interesting question when he talks about grief. Do you let someone grief over months, days, hours or minutes? Well, that’s an ethical question to me since I believe that the therapist is in service for the client. I believe you honor the client by listening to the client and or the parts. Ask the client what they need. That’s what I suppose I appreciate about Internal Family Systems is because there is a recognition that with complex trauma you are working with a dissociative system. As my previous therapist said, “you want to make sure all parts are on board”. I feel so fortunate to have been the recipient of Flash EMDR treatment. Thank you to all of you who have dedicated your lives to help people heal from trauma. Flash EMDR has been a game changer for me. I feel I have been given a new life. I also appreciated Bruce McCarter’s comment: the goal of treatment means “going beyond the script of any protocol and providing the client with the experience of being seen, heard and validated as a human being who can be knocked down by trauma [or near death
I’ve been a long-time fan of Philip Manfield after reading SPLIT SELF/SPLIT OBJECT which he wrote in a previous century (1992) . His book finally explained personality disorders and object relations theories to me.
At the neuroscience seminars I teach many people have been mentioning Phl’s Flash Technique which they say is very much like a method I demonstrate at these events. I’m glad I’ve finally had time to review the info on this site and do agree that Phil and I are doing something similar.
I use actual picture cards to get to a safe place or feel good thought. There are 24 of these up-lifting images in a set of BRAIN CHANGE CARDS. I do start out by finding cards that personify the thoughts and emotions behind their traumas or memories (broken down into groups of 8) but then they immediately look through 24 uplifting pictures and tell me what they like about them. These qualities (peace, finding possibilities, etc.) are re-framed as resources. Often when they look back at the distressing picture or even think about the associated event, it has much less charge.
There is a lot of neuroscience behind using actual visual images (The Emotional Life of Your Brain, Richard Davidson, 2012) but in addition the client and therapist have a shared experience by looking at pictures. Looking at pictures utilizes the optic nerve that creates micro saccades to maintain focus. People often pick several pictures and move their eyes between them EMDR style whilst focusing on disturbing body sensations. SUDs come down very rapidly. I’ve often thought they come down to quickly, but will need to reconsider this after reading about the Flash Technique.
I’d suggest not worrying about feeder memories. Work with whatever the patient freely offers up. When the SUDs on that memory is reduced, deeper and more threatening material will be released into conscious awareness for processing. Just keep on processing whatever comes up and that will automatically move you towards the core feeder.
It’s great that such a simple technique can completely replace the more complex EMDR. In essence we are talking about re-association, so it’s not new, but the speed component is a great breakthrough.
I am skeptical about those suggestions/assertions. In my experience, feeder memories often disrupt or block trauma processing, whether with standard EMDR/PC or with flash. Why wouldn’t we worry about them? Also who says that such a simple technique can completely replace EMDR? Nobody I’ve met. These are speculations only.
I don’t think we need to worry about feeders initially because whatever is suppressed will remain suppressed until the patient senses some degree of success and safety with the treatment of less threatening material. We provide an example of success, and the patient automatically releases more threatening material until we get to the core/feeder memory.
To go straight to the feeder is too threatening, imo. When something is too threatening, you get a lock down, dissociation or abreaction.
If going straight to the feeder would be too threatening in a given situation, there are alternatives. I don’t think that going to the later “fed” memory is a good choice, because of the feeder memory’s possible influence. We get a lot of refugees from other therapists who worked that way; the clients get overwhelmed/triggered and drop out of treatment. This is an important clinical question/strategy that we can argue, but that ultimately should be researched.
Is there a risk of misuse to be avoided; as when through a ‘therapist’s’ bias perhaps, a necessary healing engagement and resolution of an outcome effected by a client’s behavioral pathology (BPD, narcissism? ), is arbitrarily circumvented?
I’ve learned more useful stuff from this blog post reply thread than I did in three years of grad school, during which I cited several of the participants in most of the papers I wrote.
I’m new at PC and have recently begun using flash. During PC we run through “movies” of traumatic experiences in a finite amount of time, regardless of the movie’s real time duration. Could Flash be an exaggeration of this? I wonder about time outside the physical world, such as during memory recall. Could the rules be that different?
Regardless of the mechanism, the results are a wonder to behold. My deepest thanks to all of you.
40 Responses
This is a fabulous technique and great addition to the trauma-therapist tool kit. My observations so far are that the positive resource installation is a very important element and there is mastery gained from practicing the mental control of screening out the traumatic memory to focus on the positive image, as well as contamination of the traumatic memory from the positive memory. I also think there is a bit of hypnotic suggestion at work here. I look forward to hearing more about how this technique is helping both therapists and clients in their work.
Regarding two aspects of point 1 just above: “Ecker stated that Flash is only used for high-SUDS memories that the client is afraid of facing” I want to point out that both the video and transcript state that the Flash Technique also is effective for less severe SUDs Levels. And with respect to “it is also used for high-SUDS memories that the client is willing to face, but might prefer to get through more quickly” I offer this: ‘Willingness to face’ the memory is a conscious attitude, but the non-conscious attitude of the client’s emotional brain (limbic system) can even then be unwilling to allow any direct contact with the memory due to expecting to be overwhelmed and agonized by it. The conscious attitude is by no means an indicator of what the implicit, non-conscious model of the situation is. High SUDs with conscious willingness to face the memory is therefore not at odds with Ecker’s analysis.
Good points, Robin, thank you.
This is a fabulous technique and great addition to the trauma-therapist tool kit. My observations so far are that the positive resource installation is a very important element and there is mastery gained from practicing the mental control of screening out the traumatic memory to focus on the positive image, as well as contamination of the traumatic memory from the positive memory. I also think there is a bit of hypnotic suggestion at work here. I look forward to hearing more about how this technique is helping both therapists and clients in their work.
A mastery hypothesis, hypnotic suggestion… the plot thickens :^)
Ricky Greenwald also argued that it goes against my analysis of Flash Technique (proposing that it acts only upon a client’s fear of the traumatic memory, not upon the memory itself) that “Many people who experience a Flash session report changes in cognitions regarding the content of the memory, similar to changes reported in a PC or EMDR session.”
However, the mechanism I’ve proposed can result in those observed changes in memory content, in the following way.
As soon as a client’s fear of the memory is greatly dispelled by Flash Technique, the suppression of memory content can be weakened to such a degree (in some cases) that memory content immediately begins coming into awareness or near-awareness enough for mismatch detection (re-appraisal in relation to other, contradictory knowledge possessed by the client) to occur. Such mismatches can disconfirm and dissolve specific beliefs, meanings, or models that had been elements of the memory, through the memory reconsolidation process (without any facilitation of that process by the therapist). The resulting change in memory content is a by-product effect of Flash Technique having dispelled the client’s fear of the memory, and could occur without Flash Technique accessing or acting directly upon the memory at all.
The mechanism described in the previous paragraph has a testable implication: The greater the reduction of clients’ SUDs level, the more numerous, clear and decisive ought to be clients’ reports of change in specific beliefs, meanings, and models that had been elements of the memory.
As Ricky Greenwald noted, the presence of a feeder memory is found to correlate with a reduced effectiveness of Flash Technique, and he stated (in his item #3 rebutting my analysis) that “This finding implicates a mechanism of effect that is more relevant to the memory content than to fear of facing the memory.”
However, the Flash mechanism I’ve proposed, involving fear of facing the memory, can account for this observation, as follows.
Let’s consider the case where there is not only intense fear of being harmed by contacting the traumatic memory being addressed, but also a feeder memory and an intense, non-conscious, fearful expectation of being harmed by any contact with it as well. In such a case, because the two memories are strongly linked, it is reasonable to assume that the client’s high SUDs level is generated by both fears. Flash, according to my analysis, dispels the fear of the traumatic memory being addressed, but that would not also dispel the fear of the feeder memory, so the portion of the SUDs level due to fear of the feeder memory would be unaffected by Flash Technique. Thus the client’s SUDs level decreases only to the level that is due to the feeder memory. In contrast, when there is no feeder memory, the SUDs level can decrease more, even to 0 in some cases.
In that way, the analysis of Flash Technique as acting only upon the fear of the memory can account for the observation that lower effectiveness (less reduction of SUDs level) correlates with the presence of a feeder memory.
That’s a good point. Furthermore, the mechanism you proposed can account for this observation regardless of whether or not the client has a fear of facing the source/feeder memory. Or at least, Flash’s reduced effectiveness in the presence of source/feeder memories is not, as I had suggested, a reason to disconfirm your hypothesis.
Ricky Greenwald also argued that it goes against my analysis of Flash Technique (proposing that it acts only upon a client’s fear of the traumatic memory, not upon the memory itself) that “Many people who experience a Flash session report changes in cognitions regarding the content of the memory, similar to changes reported in a PC or EMDR session.”
However, the mechanism I’ve proposed can result in those observed changes in memory content, in the following way.
As soon as a client’s fear of the memory is greatly dispelled by Flash Technique, the suppression of memory content can be weakened to such a degree (in some cases) that memory content immediately begins coming into awareness or near-awareness enough for mismatch detection (re-appraisal in relation to other, contradictory knowledge possessed by the client) to occur. Such mismatches can disconfirm and dissolve specific beliefs, meanings, or models that had been elements of the memory, through the memory reconsolidation process (without any facilitation of that process by the therapist). The resulting change in memory content is a by-product effect of Flash Technique having dispelled the client’s fear of the memory, and could occur without Flash Technique accessing or acting directly upon the memory at all.
The mechanism described in the previous paragraph has a testable implication: The greater the reduction of clients’ SUDs level, the more numerous, clear and decisive ought to be clients’ reports of change in specific beliefs, meanings, and models that had been elements of the memory.
This argument highlights the value of your proposed mechanism of effect: that once the client is no longer afraid of facing the memory, other good things can happen, because the client may face and interact with the memory. However, you and Manfield (and I) seem to agree that those other good things rely on memory reconsolidation occurring within the content of the memory itself. And that is a different mechanism of effect — and in particular, a different location of effect — than the one you initially proposed.
Ricky, I’m replying here to your last two sentences above.
My proposed analysis asserts only that Flash Technique does not act DIRECTLY on the traumatic memory contents, and that what it acts upon DIRECTLY (the actual target of the technique) is the fearful expectation that any opening of awareness to the traumatic memory would be permanently agonizing and disabling. My subsequently pointing out (in comments above) an INDIRECT effect on memory contents that occurs after the direct effects is fully consistent with what I initially proposed.
And just to be clear: The direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.
In this series of comments and replies, we have considered various extra phenomena and complexities that may or may not occur in a given case of Flash Technique: the presence of a feeder memory, markers of change in the traumatic memory’s negative cognitions, and de-suppressed memory contents coming into awareness and triggering mismatch experiences. However, for the purpose of laying bare the mechanism of Flash Technique with optimal clarity, it’s best to consider first the case in which those extra complications are absent. That most basic case is what is addressed in my mini-webinar video, and the analysis given there should be understood in that context. (For example, where I stated in the mini-webinar video, “that implies that the big reduction of emotional distress produced by Flash Technique is not due to any change induced in the traumatic memory itself,” that was regarding the basic case, where the client indicates a significantly reduced SUDs level but no changes in memory content, and no feeder memory is involved.)
The extra phenomena can then be best analyzed and understood as variations and elaborations of the basic case, and I’m delighted that our discussion here in this blog seems to have made some progress in that direction.
Bruce, you wrote, “[Flash’s] direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.”
I agree that these are discrete instances of memory reconsolidation as the likely mechanism of effect in reducing the memory-associated distress. I don’t necessarily agree that nullifying the fear of the memory is the only “direct” effect of Flash. It may well be the first effect, in cases in which fear of facing the memory is present. However, I don’t see any basis to presume that the content-focused memory reconsolidation that may occur is a less “direct” effect of Flash, or less frequent or less important. The relative presence and importance of each focus may vary memory by memory. Or one or the other focus may indeed be more primary or typical. I think this can only be further clarified by researching it.
Bruce, you wrote, “[Flash’s] direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.”
I agree that these are discrete instances of memory reconsolidation as the likely mechanism of effect in reducing the memory-associated distress. I don’t necessarily agree that nullifying the fear of the memory is the only “direct” effect of Flash. It may well be the first effect, in cases in which fear of facing the memory is present. However, I don’t see any basis to presume that the content-focused memory reconsolidation that may occur is a less “direct” effect of Flash, or less frequent or less important. The relative presence and importance of each focus may vary memory by memory. Or one or the other focus may indeed be more primary or typical. I think this can only be further clarified by researching it.
I have not seen this level of excitement and enquiry in the world of EMDR for many years. I’ve been doing Flash as an exercise in trainings in recent months. Of 130 people so far, doing Flash for the first time with a training partner, we have 127/130 report a desensitising effect and 123/130 report a distancing effect (less vivid, harder to recall, et cetera) . “Clients” focused on a private memory that was not disclosed to their “therapist”.
In the last Advanced two trainings I’ve tried a variation. Rather than Flashing from the base of a positive/pleasurable experience as in Manfield’s version, I’ve had people initially develop a Positive Belief with regard to their target memory, and then explore experiences that fit with that PB, connecting with the sensory and affective elements of that memory. This provides a better juxtaposition experience than standard Flash.
Not only are we still seeing the same distancing and desensitising effects as standard Flash, but most people also report significant cognitive shifts, towards a VoC of 6 or 7.
Some of my trainees have given me feedback about trying this with clients, and whilst the numbers are small at this stage, or the results have been positive. In other words we getting the same processing effects we see with EMDR – distancing, desensitisation and adaptive cognitive shifts – without actually doing EMDR.
Very interesting. In the PC version of Flash, we start with the beginning of the story (well before the bad part) and end with the ending of the story (well after any bad part). This also provides a memory-specific contrast to the memory, similar to the positive cognition sandwich. Though different as well. I’ve also tried it (with counting, which is the PC version) with an unrelated feel-good image to start and end, but the memory-related beginning and ending work better. These findings are consistent with the memory reconsolidation account in that the beginnings and endings, as well as the positive cognition sandwich, structure in disconfirmation of at least one negative aspect of the memory.
Ricky, I’m replying here to your last two sentences above.
My proposed analysis asserts only that Flash Technique does not act DIRECTLY on the traumatic memory contents, and that what it acts upon DIRECTLY (the actual target of the technique) is the fearful expectation that any opening of awareness to the traumatic memory would be permanently agonizing and disabling. My subsequently pointing out (in comments above) an INDIRECT effect on memory contents that occurs after the direct effects is fully consistent with what I initially proposed.
And just to be clear: The direct effect (on the fear of the memory) and the indirect effect (on the memory itself) are separate instances of the memory reconsolidation process nullifying an emotional learning.
In this series of comments and replies, we have considered various extra phenomena and complexities that may or may not occur in a given case of Flash Technique: the presence of a feeder memory, markers of change in the traumatic memory’s negative cognitions, and de-suppressed memory contents coming into awareness and triggering mismatch experiences. However, for the purpose of laying bare the mechanism of Flash Technique with optimal clarity, it’s best to consider first the case in which those extra complications are absent. That most basic case is what is addressed in my mini-webinar video, and the analysis given there should be understood in that context. (For example, where I stated in the mini-webinar video, “that implies that the big reduction of emotional distress produced by Flash Technique is not due to any change induced in the traumatic memory itself,” that was regarding the basic case, where the client indicates a significantly reduced SUDs level but no changes in memory content, and no feeder memory is involved.)
The extra phenomena can then be best analyzed and understood as variations and elaborations of the basic case, and I’m delighted that our discussion here in this blog seems to have made some progress in that direction.
I have not seen this level of excitement and enquiry in the world of EMDR for many years. I’ve been doing Flash as an exercise in trainings in recent months. Of 130 people so far, doing Flash for the first time with a training partner, we have 127/130 report a desensitising effect and 123/130 report a distancing effect (less vivid, harder to recall, et cetera) . “Clients” focused on a private memory that was not disclosed to their “therapist”.
In the last Advanced two trainings I’ve tried a variation. Rather than Flashing from the base of a positive/pleasurable experience as in Manfield’s version, I’ve had people initially develop a Positive Belief with regard to their target memory, and then explore experiences that fit with that PB, connecting with the sensory and affective elements of that memory. This provides a better juxtaposition experience than standard Flash.
Not only are we still seeing the same distancing and desensitising effects as standard Flash, but most people also report significant cognitive shifts, towards a VoC of 6 or 7.
Some of my trainees have given me feedback about trying this with clients, and whilst the numbers are small at this stage, or the results have been positive. In other words we getting the same processing effects we see with EMDR – distancing, desensitisation and adaptive cognitive shifts – without actually doing EMDR.
Having read the various comments in this blog, I thought I’d weigh in with some additional data.
It is not uncommon that a client begins receiving flash technique without any expectation of what is supposed to happen. Clients are told that they should not think about or bring to mind the disturbing memory. They are also cautioned not to try to evaluate whether this process is accomplishing anything, because to do that they would need to think of the memory, and we don’t want them to do that. For some, not all clients, after five triple flashes (less than five minutes), they are asked if they notice any change in the memory. In some cases, the dialog might go like this: “I know I told you not to think of the memory. Were you able to do that?” ”Yes” “Well, now, I’d like you to actually think of it, and notice if there is any change at all.” “Well, yes, something has changed.” “What is it?” “Well, it’s not disturbing anymore,” or “I can hardly bring it up,” or “The emotions seem separated from the memory.”
These complete five minute resolutions are not uncommon. At each of the webinars we have been producing every two months, we typically have done five live demonstrations of approximately five minutes each. Some of them play out very much like this. One woman wrote in the chat section about thirty minutes after being a demonstration client, “I’ve been working on that issue for seven years, and I can’t believe it’s not upsetting anymore.”
For the purposes of this discussion, the important feature of this interaction is that the client has not evaluated his or her progress, and so has noticed no change. There is no expectation error until they realize that the memory is no longer disturbing. Typically, for these clients, adaptive adult perspectives (cognitions) spontaneously arise. Sometimes, the clients appear dumbfounded and say, “What happened?” From the point of view of memory reconsolidation, this phenomenon is hard to explain. In my view, the processing occurred at this accelerated rate because conscious defenses were not engaged. Also, the client was prevented from reliving the memory, and observing from the present adult perspective becomes clear that it is in the past and over.
An interesting article that is worth considering is “Towards an Unconscious Neurotherapy for Common Fears” (Vincent Taschereau-Dumouchel Vincent, et.al, 2017) These researchers used FMRI to identify locations in the brain that tended to store typical phobia reactions, like snakes and spider. They were able to stimulate those parts of the brain while having subjects think of other things. The subjects chosen had both spider and snake phobias, and only one was processed. The client did not know which one was being processed and, like with flash, had NO experience of the fear. Yet, significant easing of the target fear was accomplished without any effect on the non-targetted fear. This study and a few others lend credence to the claim that trauma can be processed without the client consciously accessing the memory.
Full citation: Taschereau-Dumouchel, Aurelio Cortese, Toshinori Chiba, J. D. Knotts, Mitsuo Kawato, Hakwan Lau, , July 30, 2017 (This article has not been peer reviewed)
Having read the various comments in this blog, I thought I’d weigh in with some additional data.
It is not uncommon that a client begins receiving flash technique without any expectation of what is supposed to happen. Clients are told that they should not think about or bring to mind the disturbing memory. They are also cautioned not to try to evaluate whether this process is accomplishing anything, because to do that they would need to think of the memory, and we don’t want them to do that. For some, not all clients, after five triple flashes (less than five minutes), they are asked if they notice any change in the memory. In some cases, the dialog might go like this: “I know I told you not to think of the memory. Were you able to do that?” ”Yes” “Well, now, I’d like you to actually think of it, and notice if there is any change at all.” “Well, yes, something has changed.” “What is it?” “Well, it’s not disturbing anymore,” or “I can hardly bring it up,” or “The emotions seem separated from the memory.”
These complete five minute resolutions are not uncommon. At each of the webinars we have been producing every two months, we typically have done five live demonstrations of approximately five minutes each. Some of them play out very much like this. One woman wrote in the chat section about thirty minutes after being a demonstration client, “I’ve been working on that issue for seven years, and I can’t believe it’s not upsetting anymore.”
For the purposes of this discussion, the important feature of this interaction is that the client has not evaluated his or her progress, and so has noticed no change. There is no expectation error until they realize that the memory is no longer disturbing. Typically, for these clients, adaptive adult perspectives (cognitions) spontaneously arise. Sometimes, the clients appear dumbfounded and say, “What happened?” From the point of view of memory reconsolidation, this phenomenon is hard to explain. In my view, the processing occurred at this accelerated rate because conscious defenses were not engaged. Also, the client was prevented from reliving the memory, and observing from the present adult perspective becomes clear that it is in the past and over.
An interesting article that is worth considering is “Towards an Unconscious Neurotherapy for Common Fears” (Vincent Taschereau-Dumouchel Vincent, et.al, 2017) These researchers used FMRI to identify locations in the brain that tended to store typical phobia reactions, like snakes and spider. They were able to stimulate those parts of the brain while having subjects think of other things. The subjects chosen had both spider and snake phobias, and only one was processed. The client did not know which one was being processed and, like with flash, had NO experience of the fear. Yet, significant easing of the target fear was accomplished without any effect on the non-targetted fear. This study and a few others lend credence to the claim that trauma can be processed without the client consciously accessing the memory.
Full citation: Taschereau-Dumouchel, Aurelio Cortese, Toshinori Chiba, J. D. Knotts, Mitsuo Kawato, Hakwan Lau, , July 30, 2017 (This article has not been peer reviewed)
Phil, thanks for weighing in here. It sounds like you’re moving away from the memory reconsolidation account towards something else. But couldn’t memory reconsolidation still be occurring even if not at the conscious level? It also sounds like the Flash technique is continuing to evolve, and you now do an even more avoid-the-memory version than what was described in your article. And others such as Graham Taylor and I are experimenting with different types of bread for the sandwich, so to speak. The introduction of Flash, along with further innovations, research, and discussions like these, will likely lead to a better understanding of how trauma healing works.
I think these discussions and innovation in the field are outstanding and right at the cutting edge of trauma therapy. It is also edifying that this is happening in a spirit of cooperation that is not always present in our profession.
I do agree with Phil, and have experimented myself with getting the briefest and smallest possible ‘exposure’ to the memory as possible, which makes Flash safer and more usable by a wider audience. Until I listened to Phil’s webinar, I didn’t realise the degree to which this is possible – ie clients wondering whether they have actually ‘flashed’ to the trauma at all for example. My own experiment recently was to use the metaphor of a piece of paper on the table, with the trauma on the underside of it completely out of view. The instruction ‘go flash’ was for clients to briefly glance at the paper (not the underside) and then reconnection with engaging place. For me, this seemed to minimise ‘sliding into’ any trauma memory.
Preventing clients dropping into, or dissociating out of severe trauma is really important, and the more the protocol can safeguard against this the better.
Long may this work continue, and evolve as the finest trauma interventions ever seen!
I have just listened to Bruce’s full youtube commentary, which is very interesting. My only observation is that I have used Flash with memories that don’t fall into the ‘if I look at this memory, I will be overwhelmed’etc. category, and it works perfectly well. ie memories that don’t have ‘lethal status’.
Therefore, I think Bruce might be overreaching himself in his hypothesis and the distinction between ‘fear of the memory’ and the memory itself.
So, I think Flash is processing the traumatic memory – the full mechanism, and also the degree to which this is achieved in practice, needs further research. I think the feeder memory theory holds some truth.
For a client where Flash didn’t work, moving into standard EMDR processing also didn’t work until the feeder memory was located and processed
I think these discussions and innovation in the field are outstanding and right at the cutting edge of trauma therapy. It is also edifying that this is happening in a spirit of cooperation that is not always present in our profession.
I do agree with Phil, and have experimented myself with getting the briefest and smallest possible ‘exposure’ to the memory as possible, which makes Flash safer and more usable by a wider audience. Until I listened to Phil’s webinar, I didn’t realise the degree to which this is possible – ie clients wondering whether they have actually ‘flashed’ to the trauma at all for example. My own experiment recently was to use the metaphor of a piece of paper on the table, with the trauma on the underside of it completely out of view. The instruction ‘go flash’ was for clients to briefly glance at the paper (not the underside) and then reconnection with engaging place. For me, this seemed to minimise ‘sliding into’ any trauma memory.
Preventing clients dropping into, or dissociating out of severe trauma is really important, and the more the protocol can safeguard against this the better.
Long may this work continue, and evolve as the finest trauma interventions ever seen!
I have just listened to Bruce’s full youtube commentary, which is very interesting. My only observation is that I have used Flash with memories that don’t fall into the ‘if I look at this memory, I will be overwhelmed’etc. category, and it works perfectly well. ie memories that don’t have ‘lethal status’.
Therefore, I think Bruce might be overreaching himself in his hypothesis and the distinction between ‘fear of the memory’ and the memory itself.
So, I think Flash is processing the traumatic memory – the full mechanism, and also the degree to which this is achieved in practice, needs further research. I think the feeder memory theory holds some truth.
For a client where Flash didn’t work, moving into standard EMDR processing also didn’t work until the feeder memory was located and processed.
What a rich, interesting, and enjoyably collegial exploration this is. In response to the more recently added comments, I’ll add these thoughts:
Some of the comments above seem to assume that if a client initially does not consciously feel fear of experiencing the target traumatic memory, it means there is no significant fear of the memory (and then the Flash mechanism I’ve proposed wouldn’t be relevant). But, of course, there is much more happening than a client is consciously aware of, as a rule. It is commonplace in therapy for it to emerge that the client has a major fear (or other emotion) that has been completely outside of awareness.
For example, I once had a client who had a whole array of diverse compulsive behaviors he wanted to shed. We found that every one of those behaviors was a way to avoid a situation or activity that would bring a heightened sense of aloneness, which was urgent to avoid because it would feel like he was sliding back into the terrifying and desolate aloneness he suffered throughout childhood. Before therapy he had no conscious awareness that he was terrified of aloneness, though that fear was ruling his life. His many avoidance and self-distraction tactics had been doing their job well, so he rarely felt aloneness and never noticed his great fear of it.
My point is that clients’ reports of what they consciously feel or don’t feel is hardly a complete account of their psychological process, and if we think it is, we are likely to arrive at false conclusions.
Furthermore, here in this discussion of Flash Technique we’re dealing with unprocessed *traumatic* memory. By definition, a traumatic memory contains an ordeal, an agonizing, intensely frightening experience. So, it seems extremely unlikely that a client could have little or no disowned, suppressed fear of bringing the memory of such an experience into direct awareness and affective re-experiencing. Fear of the memory could be intense and yet be entirely outside of awareness. Non-conscious fear is just as effective at blocking access to the memory as conscious fear is.
Such fear of the memory is based in the expectation that experiencing the memory would bring intense, prolonged suffering. That expectation is what my analysis of Flash Technique proposes is the actual direct target of the technique. With that expectation disconfirmed and dissolved via memory reconsolidation, the memory is now safe for accessing, so accessing is now allowed by the emotional brain systems. It’s at this point, with the memory unblocked and readily accessible, that the contents of the memory could juxtapose with adaptive adult knowings and be disconfirmed and dissolved. I view that as a by-product effect of Flash Technique, not its direct action, though of course it’s the most important effect of all.
Phil Manfield wrote above, “Typically, for these clients, adaptive adult perspectives (cognitions) spontaneously arise.” But what causes this spontaneous arising? They arise, I suggest, because the now unblocked memory has automatically been subjected to mismatch detection, and adult knowings that don’t match what’s in the memory get activated and pop forward into awareness. That is how the “expectation error” (and memory reconsolidation) would be occurring here, and it can occur in the background, without having the client’s attention (so I agree with Ricky’s comment, “couldn’t memory reconsolidation still be occurring even if not at the conscious level?”). This explanation predicts that the adult knowings that arise spontaneously are always ones that contradict some part of the traumatic memory schema. They arise *because* they contradict the memory.
Bottom line: Everything Phil describes can be accounted for in terms of memory reconsolidation, with no unexplained gaps. That doesn’t prove anything, but it’s important to recognize that we have a candidate model that is consistent and complete.
First, I would like to express my gratitude to Dr. Manfield for describing and sharing his unique and intriguing approach to facilitated treatment of trauma patients. I would also like to thank Dr. Greenwald for providing this forum for informed discussion.
I would like to provide an alternative perspective in this enlightened discussion of the Flash Technique. Let’s bear in mind that this is a complex topic that is clearly unsettled, despite various spirited assertions of a definitive explanation that conforms to a pre-existing paradigm. I offer an alternative postulation of the principles underlying the effectiveness of the Flash Technique, as well as a different perspective on the memory reconsolidation process itself.
I prefer to look at things from an evolutionary psychology perspective, which I think is particularly applicable and valid in this setting. The ability to achieve memory reconsolidation, as well as revision is hard-wired, suggesting an evolutionary survival benefit to this process. We know from rat studies as well as human brain imaging that the amygdala (fight or flight center) is intimately involved in traumatic memory “intake” and retrieval, further supporting the hypothesized evolutionary survival benefit. I subscribe to the hypothesis that traumatic memories remain “unprocessed” in the brain, allowing the organism to maintain ongoing access to the information and thereby avoid further pain similar to the index event, facilitating an evolutionary survival benefit..
A proposed explanation for the evolutionary advantage of memory reconsolidation is to reinforce and “strengthen” the threatening memory, assisting the organism in avoiding pain and consequently promoting survival. Immediate access to “comparative” information from the prior perceived threat can be immediately utilized to assist survival in the face of a perceived similar threat situation. This hypothesis also provides a rational explanation for the “triggers” present in trauma sufferers. Similarly, the evolutionary justification for hypervigilance and thought intrusion is evident.
The process of memory reconsolidation interference and revision is proposed to be an adaptive mechanism that allows the existing fear based memory to be updated, and thereby incorporate new information which may be disconfirming to the preexisting working schema supported by the specific memory. This process would be evolutionarily beneficial to the species by allowing the organism to adapt and better survive in changing environmental conditions. In rats, the required expectancy violation appears to have a narrow degree of allowance to provide the acceptable conditions that allow for memory reconsolidation interference and reconsolidation. The applicability of this finding in rats to the process in humans is uncertain at this time. The much more complex human interactions, perceptions, and attributed meanings would logically be expected to introduce a multitude of variables, and exponentially complicate our assessment of conditions necessary to provide an expectancy violation. Although there are several theories regarding the expectancy violation requirements in humans, this complex issue is understandably not well defined or understood at present. It appears to encompass much more complexity than an overt juxtaposition and cognitive realization of an emotional learning mismatch, although this certainly can be profoundly effective if realized experientially. I believe that the dissolution of negative cognitions and replacement with positive cognitions can often be explained as a result of, rather than a cause of expectancy violation. (Further discussed below.) It seems apparent that whatever the target, the predictive error must be experientially realized by the individual to be effective.
If you accept this explanation, then the rational justification for fear of traumatic memory content recall becomes almost self-evident. The inner mind (subconscious) maintains the memory in an “activated state”, believing that the event is still occurring, (on a subconscious level, outside of the realm of conscious realization.) A person’s conscious fear of direct recall of the content can be explained on the basis of a fear of “reliving” the event, recreating an overwhelming perceived threat to survival. So, although the inner mind is continuously trying to keep the memory active and alive to protect the organism, the conscious mind is vigorously trying to defend itself against the perceived threat to survival. Thus the resultant inner struggle and suffering associated with PTSD subjects as well as other trauma victims.
Therapeutic assistance in creating some type of predictive error that the brain accepts, which then promotes memory reconsolidation interference and revision can be effectively utilized to “extinguish the ongoing perceived threat assessment”, and thereby “strip” the profoundly upsetting emotional overlay; allowing the brain to fully “process” the memory, and resolve the internal struggle. The basis for this brain “glitch” that creates the distress can be viewed as a direct result of an evolutionarily hard-wired mechanism that has been inappropriately activated secondary to an environmental mismatch (very different from a predictive error).
I believe that this paradigm provides a logical evolutionarily and intellectually based justification for the fear of conscious traumatic memory recall, which can be applied to the understanding of the beneficial effects of the Flash Technique as well as multiple other effective strategic therapies.
The actual predictive error mismatch that Dr. Manfield’s technique presumably effects, to at times achieve a SUDS=0 effect is intriguing to speculate about. (Of course there are multiple variables related to the assumed clinical benefit proposed by that assertion, not the least of which is the duration of relief and the generalization of the result.) Briefly, let’s consider if such a brief recollection could be sufficient to activate the neuronal pathway for reconsolidation. The additional references that he provides in his article, including the above reference regarding subconscious reconsolidation revision suggests that this is indeed possible. There are other described therapeutic interventions (beyond the scope of this discussion) which appear to resolve suffering through a memory reconsolidation interference and revision mechanism, while involving only a limited or cursory activation of the traumatic memory, rather than an extensive and detailed “re-experiencing”. The Flash Technique certainly represents the extreme end of this spectrum.
Regarding the predictive error mismatch, there are multiple techniques that have been demonstrated to be effective in achieving an “effortless and permanent” resolution of suffering related to a prior trauma, but do not fit into the “traditional” memory reconsolidation mismatch paradigm. I would submit that there are multiple complex effective targets of expectancy violation, including emotional mismatch, and “time mismatch”, as postulated by Dr. Manfield in his article describing the Flash Technique. I personally feel that it is logical and rational to believe that the requirements for an individual’s brain to experientially realize” an expectancy error sufficient to invalidate an underlying schema are highly variable and not always easily discernible or classifiable. Utilizing the model whereby a traumatic memory is “unprocessed” and the subconscious mind believes that the trauma is ongoing, the rationale of a “time mismatch” as a prevalent source of effective mismatch can be clearly envisioned.
A partial reduction of the SUD level with the Flash Technique does not support Ecker’s assertion that only the fear of the memory recall itself has been reduced, and therefore the remaining upset must be due to the content of the memory, which has not been addressed. There are multiple reasons for a lack of complete resolution of distress, not the least of which is the absence of an intentioned target of predictive error, resulting in only a “partial disconfirmation” of expectancy. This outcome does not invalidate the existence of an expectancy violation related to the original traumatic memory as an explanation of its underlying mechanistic process. Ecker’s reasoning is an invalid “the exception proves the rule” assertion. Animal studies and empiric data suggest multiple sources of potential reduced or absent efficacy.
Additionally, I would suggest that the “adaptive adult perspectives (cognitions)” that “spontaneously arise”, as stated by Dr. Manfield were most likely a result of an emotional “stripping” of the memory, created by a “non-cognitive” expectancy violation, rather than an integral part of the disconfirmation process itself. I would submit that once the traumatic memory is “processed”, the associated negative cognitions are no longer supported, and thereby “dissolve”, allowing the “spontaneous” emergence of adaptive positive cognitions, just as Dr. Manfield describes. i.e. I am wearing very dark glasses outside, and everything looks dark and gloomy. I then remove the glasses, and I am now able to spontaneously appreciate the bright and colorful nature of the world, as I am no longer constrained by the dark lenses.
So, to summarize, I would assert that the actual target of the predictive error is the memory content itself, and the “fear of recalling a memory” as the target of the predictive error is illogical from an evolutionary psychological perspective. I believe that the above proposed hypothesis is logically coherent with the evolutionary development and hard-wiring of the memory reconsolidation and revision process in the human as well as animal CNS. Furthermore, empirical evidence in humans supports the idea that there are indeed multiple and varied targets of an expectancy violation that can be exploited to achieve memory reconsolidation interference and revision. The requirements for expectancy violation appear to be extremely complex and quite variable from individual to individual, and this remains an area of active research and investigation.
I appreciate the willingness of Drs. Greenwald and Manfield to remain unconstrained by current memory reconsolidation paradigms, thereby maintaining an open-minded perspective; thus promoting the advancement of additional novel, efficient and effective methods that allow us to treat and resolve trauma in those in whom “the past is present”.
Thank you Ricky for hosting this interesting discussion. I would like to introduce one question into this dialogue. While I am very excited to hear about the reported successes of the evolving Flash technique, and I can certainly see its utility in working with people struggling with complex trauma histories, thus allowing folks to process traumas that were previously too extreme to tolerate thinking about, I find myself wondering about your long term goals of treatment. If a client is able to process a traumatic memory without consciously reviewing it are they actually gaining mastery? are they integrating the experience in a manner that leaves them with an internalized roadmap for processing and mastering traumatic experiences on their own, outside of therapy? In my mind processing trauma is not just about reducing the SUD’s to 1 or 0. Rather it includes helping the client recognize that they can go through something terrible, become paralyzed by intolerable helplessness or shame, and then, through treatment, see that their frailty is part of what makes them human, and that they can survive it. They can come out on the other side. This is important because it reduces their feelings of shame and helplessness as they face other challenges and potentially traumatic experiences as they continue to move through their lives. So, my question is, after Flash processing intolerable trauma on an unconscious or partially conscious level would you be content with that just because the SUD’s went down? Or would you eventually come back around and review those traumatic experiences on a more conscious level after they have been desensitized? (incorporating future template, etc), thus adding to the clients growing sense of resilience and mastery, and reducing their vulnerability to shame and helplessness in the future.
I guess this is the old question of whether the goal of treatment is to just return the client to adaptive functioning (some may call this applying a band-aid), or to facilitate growth and resilience so that they are able to witness whatever arises in their lives without remaining embedded and stuck in reactive patterns that perpetuate negative and debilitating belief systems. For me this means going beyond the script of any protocol and providing the client with the experience of being seen, and known, and validated as a human being who can be knocked down by trauma but then get back up with renewed confidence and wisdom.
In either case the work that you all (Phil, Bruce, Ricky, and others) are doing is clearly moving the field of trauma treatment forward in exciting ways. I tip my hat
Bruce I love your question! Here’s my own answer, as far as it goes:
I don’t think what you’ve described is the difference between healing vs. band-aid. You get healing either way. The question is whether the more effortless healing of Flash might deprive the client of the valuable experience of working for/through the healing.
I think this is in part a philosophical question and in part a practical one. If someone can’t otherwise do the trauma work, then starting with Flash makes the rest of it possible. OTOH if the person can do it, is it still OK to do it faster?
Wasn’t that same question posed regarding EMDR, all those years ago? For example: Do you let someone do their normal grief processing over months or years, or in minutes or hours via EMDR?
I’ve generally been in the “go for it” camp, provided that the client wants to do that as well. However, even with EMDR, there is a sense of doing the work, even if quickly. With Flash, the question is raised in a new way. I don’t know the answer.
Thank you Ricky for hosting this interesting discussion. I would like to introduce one question into this dialogue. While I am very excited to hear about the reported successes of the evolving Flash technique, and I can certainly see its utility in working with people struggling with complex trauma histories, thus allowing folks to process traumas that were previously too extreme to tolerate thinking about, I find myself wondering about your long term goals of treatment. If a client is able to process a traumatic memory without consciously reviewing it are they actually gaining mastery? are they integrating the experience in a manner that leaves them with an internalized roadmap for processing and mastering traumatic experiences on their own, outside of therapy? In my mind processing trauma is not just about reducing the SUD’s to 1 or 0. Rather it includes helping the client recognize that they can go through something terrible, become paralyzed by intolerable helplessness or shame, and then, through treatment, see that their frailty is part of what makes them human, and that they can survive it. They can come out on the other side. This is important because it reduces their feelings of shame and helplessness as they face other challenges and potentially traumatic experiences as they continue to move through their lives. So, my question is, after Flash processing intolerable trauma on an unconscious or partially conscious level would you be content with that just because the SUD’s went down? Or would you eventually come back around and review those traumatic experiences on a more conscious level after they have been desensitized? (incorporating future template, etc), thus adding to the clients growing sense of resilience and mastery, and reducing their vulnerability to shame and helplessness in the future.
I guess this is the old question of whether the goal of treatment is to just return the client to adaptive functioning (some may call this applying a band-aid), or to facilitate growth and resilience so that they are able to witness whatever arises in their lives without remaining embedded and stuck in reactive patterns that perpetuate negative and debilitating belief systems. For me this means going beyond the script of any protocol and providing the client with the experience of being seen, and known, and validated as a human being who can be knocked down by trauma but then get back up with renewed confidence and wisdom.
In either case the work that you all (Phil, Bruce, Ricky, and others) are doing is clearly moving the field of trauma treatment forward in exciting ways. I tip my hat.
Ronald Weiss, you wrote:
“ I would assert that the actual target of the predictive error is the memory content itself, and the “fear of recalling a memory” as the target of the predictive error is illogical from an evolutionary psychological perspective.”
I respectfully disagree that the “fear of recalling a memory” isn’t logical, evolutionarily-speaking. What we’re calling “a memory” is actually a terrifying, lived experience. It makes sense to me that we can be both terrified of bad things happening, and terrified of becoming terrified, again. It is quite common that people become afraid of both the contents of their mind, and of thinking or feeling itself. To avoid “bad” and seek “good”, be that thoughts, feelings, or “anticipatory bad”, has evolutionary value, IMO.
Bruce McCarter, I love your question/comment too. IMO, whether we seek to go beyond SUDS reduction really depends upon the patient and their goals. As we all know, some seek only symptom relief, and others seek a deepening awareness of self, other, relationship and a more meaningful life. Furthermore, some seek and find the latter with their therapist, and some seek and find it in other, extra therapy relationships.
Speaking of relationships, I recognize this may seem “old school”, but most so-called trauma memories are, in my patients, about having been hurt in relationship. Whatever flash or any other technique may accomplish, I for one never minimize the power that my patient and I are doing this work together. A therapeutic relationship is, at times, the most powerful mismatch experience of all.
Ronald Weiss, you wrote:
“ I would assert that the actual target of the predictive error is the memory content itself, and the “fear of recalling a memory” as the target of the predictive error is illogical from an evolutionary psychological perspective.”
I respectfully disagree that the “fear of recalling a memory” isn’t logical, evolutionarily-speaking. What we’re calling “a memory” is actually a terrifying, lived experience. It makes sense to me that we can be both terrified of bad things happening, and terrified of becoming terrified, again. It is quite common that people become afraid of both the contents of their mind, and of thinking or feeling itself. To avoid “bad” and seek “good”, be that thoughts, feelings, or “anticipatory bad”, has evolutionary value, IMO.
Bruce McCarter, I love your question/comment too. IMO, whether we seek to go beyond SUDS reduction really depends upon the patient and their goals. As we all know, some seek only symptom relief, and others seek a deepening awareness of self, other, relationship and a more meaningful life. Furthermore, some seek and find the latter with their therapist, and some seek and find it in other, extra therapy relationships.
Speaking of relationships, I recognize this may seem “old school”, but most so-called trauma memories are, in my patients, about having been hurt in relationship. Whatever flash or any other technique may accomplish, I for one never minimize the power that my patient and I are doing this work together. A therapeutic relationship is, at times, the most powerful mismatch experience of all.
I have been reading these comments with interest since I have been actually been receiving Flash EMDR treatment so in some sense I feel I am in a unique experience to describe what is actually happening to me: emotionally, physiologically and existentially. I will keep my comments brief. Though I could probably produced pages of text. I think Dr. Greenwald hits the nail on its head with his last comment. It depends on how you define integration or healing. I prefer Carl Jung’s definition insofar as our human experience is part of an individuation experience. There really is no beginning or end. However, from the practical perspective, both the therapist and the client need to come to some understanding about when the work is done. EMDR and Flash EMDR have helped me deal with intense emotional experiences (including a violent Near Death Experience) — and I am still of the opinion that it is the relational repair or connection to the therapist as well as other healthy individuals in one’s community that is the most essential component. Please know that your client needs to know that they are not alone. Even if you have ‘installed’ the positive emotional state, and your client can go there, your client still needs to feel your presence with ‘eye contact’ or ‘smile’ or the holding of your hand. Stephen Porges, Dan Siegel, Bruce Perry, Peter Levine and many other trauma neuroscientic informed experts makes the same point, but in different ways about the inportance of connection. Polyvagal theory is relevant in this regard. Also, I have experienced the ‘after effects’ of Flash EMDR. It’s not done with reconsolidation after the appointment. The effects linger into the night as I sleep and a couple of days later in my experience. I ‘know’ my brain is still trying to adjust to the Flash EMDR experience. I have had a profound neurophysiological shift occur in my body as a result of all the Flash EMDR sessions in a relatively short span of time. That can be a shock to one’s neurophysiology. As Bessel van der Kolk says, “The Body Keeps the Score”… It’s not just my brain that’s integrating, my body is trying to integrate or make sense of the experience of Flash EMDR. How do I honor what my body needs during any moment is a central consideration. My body contains bodily memories from decades ago – this stuff is not just trauma that has been stuffed in my brain. For example, I had high blood pressure before Flash EMDR. Now my blood pressure is normal I assuming because my parts are no longer stuck in FIGHT response. I have also experienced changes in my digestive system. I believe it’s essential to listen to to what the body needs. Sometimes my body needs to discharge the energy. Sometimes I need to sleep and adjustment needs to be made to diet, exercise and activities as my body continues to adjust and play catch up with the changes in my brain. This takes time. The process of healing is best not rushed. Trust your client. Healing or integration is a lot about timing and pacing while honoring the client who should be encouraged to listen to their own body and listen to their dreams! Dreams are the gateway to the unconscious. They will tell you a lot about where your client needs to go if you listen. I would also like to make the point, while Flash EMDR is an exciting advance, there’s still so much more we don’t know about the brain and memory reconsolidation. How is it possible for my brain to process memories that are outside my level of conscious awareness? Is Flash EMDR a form of hypnosis that simply bypasses the defenses or ‘parts’ so that ‘they’ cannot interfere with the process — because ‘parts’ do emerge and those ‘parts’ need to be honored (in my experience). Otherwise, whatever intervention you are attempting might end up backfiring on you. Dr. Greenwald also poses an interesting question when he talks about grief. Do you let someone grief over months, days, hours or minutes? Well, that’s an ethical question to me since I believe that the therapist is in service for the client. I believe you honor the client by listening to the client and or the parts. Ask the client what they need. That’s what I suppose I appreciate about Internal Family Systems is because there is a recognition that with complex trauma you are working with a dissociative system. As my previous therapist said, “you want to make sure all parts are on board”. I feel so fortunate to have been the recipient of Flash EMDR treatment. Thank you to all of you who have dedicated your lives to help people heal from trauma. Flash EMDR has been a game changer for me. I feel I have been given a new life. I also appreciated Bruce McCarter’s comment: the goal of treatment means “going beyond the script of any protocol and providing the client with the experience of being seen, heard and validated as a human being who can be knocked down by trauma [or near death
I have been reading these comments with interest since I have been actually been receiving Flash EMDR treatment so in some sense I feel I am in a unique experience to describe what is actually happening to me: emotionally, physiologically and existentially. I will keep my comments brief. Though I could probably produced pages of text. I think Dr. Greenwald hits the nail on its head with his last comment. It depends on how you define integration or healing. I prefer Carl Jung’s definition insofar as our human experience is part of an individuation experience. There really is no beginning or end. However, from the practical perspective, both the therapist and the client need to come to some understanding about when the work is done. EMDR and Flash EMDR have helped me deal with intense emotional experiences (including a violent Near Death Experience) — and I am still of the opinion that it is the relational repair or connection to the therapist as well as other healthy individuals in one’s community that is the most essential component. Please know that your client needs to know that they are not alone. Even if you have ‘installed’ the positive emotional state, and your client can go there, your client still needs to feel your presence with ‘eye contact’ or ‘smile’ or the holding of your hand. Stephen Porges, Dan Siegel, Bruce Perry, Peter Levine and many other trauma neuroscientic informed experts makes the same point, but in different ways about the inportance of connection. Polyvagal theory is relevant in this regard. Also, I have experienced the ‘after effects’ of Flash EMDR. It’s not done with reconsolidation after the appointment. The effects linger into the night as I sleep and a couple of days later in my experience. I ‘know’ my brain is still trying to adjust to the Flash EMDR experience. I have had a profound neurophysiological shift occur in my body as a result of all the Flash EMDR sessions in a relatively short span of time. That can be a shock to one’s neurophysiology. As Bessel van der Kolk says, “The Body Keeps the Score”… It’s not just my brain that’s integrating, my body is trying to integrate or make sense of the experience of Flash EMDR. How do I honor what my body needs during any moment is a central consideration. My body contains bodily memories from decades ago – this stuff is not just trauma that has been stuffed in my brain. For example, I had high blood pressure before Flash EMDR. Now my blood pressure is normal I assuming because my parts are no longer stuck in FIGHT response. I have also experienced changes in my digestive system. I believe it’s essential to listen to to what the body needs. Sometimes my body needs to discharge the energy. Sometimes I need to sleep and adjustment needs to be made to diet, exercise and activities as my body continues to adjust and play catch up with the changes in my brain. This takes time. The process of healing is best not rushed. Trust your client. Healing or integration is a lot about timing and pacing while honoring the client who should be encouraged to listen to their own body and listen to their dreams! Dreams are the gateway to the unconscious. They will tell you a lot about where your client needs to go if you listen. I would also like to make the point, while Flash EMDR is an exciting advance, there’s still so much more we don’t know about the brain and memory reconsolidation. How is it possible for my brain to process memories that are outside my level of conscious awareness? Is Flash EMDR a form of hypnosis that simply bypasses the defenses or ‘parts’ so that ‘they’ cannot interfere with the process — because ‘parts’ do emerge and those ‘parts’ need to be honored (in my experience). Otherwise, whatever intervention you are attempting might end up backfiring on you. Dr. Greenwald also poses an interesting question when he talks about grief. Do you let someone grief over months, days, hours or minutes? Well, that’s an ethical question to me since I believe that the therapist is in service for the client. I believe you honor the client by listening to the client and or the parts. Ask the client what they need. That’s what I suppose I appreciate about Internal Family Systems is because there is a recognition that with complex trauma you are working with a dissociative system. As my previous therapist said, “you want to make sure all parts are on board”. I feel so fortunate to have been the recipient of Flash EMDR treatment. Thank you to all of you who have dedicated your lives to help people heal from trauma. Flash EMDR has been a game changer for me. I feel I have been given a new life. I also appreciated Bruce McCarter’s comment: the goal of treatment means “going beyond the script of any protocol and providing the client with the experience of being seen, heard and validated as a human being who can be knocked down by trauma [or near death
I’ve been a long-time fan of Philip Manfield after reading SPLIT SELF/SPLIT OBJECT which he wrote in a previous century (1992) . His book finally explained personality disorders and object relations theories to me.
At the neuroscience seminars I teach many people have been mentioning Phl’s Flash Technique which they say is very much like a method I demonstrate at these events. I’m glad I’ve finally had time to review the info on this site and do agree that Phil and I are doing something similar.
I use actual picture cards to get to a safe place or feel good thought. There are 24 of these up-lifting images in a set of BRAIN CHANGE CARDS. I do start out by finding cards that personify the thoughts and emotions behind their traumas or memories (broken down into groups of 8) but then they immediately look through 24 uplifting pictures and tell me what they like about them. These qualities (peace, finding possibilities, etc.) are re-framed as resources. Often when they look back at the distressing picture or even think about the associated event, it has much less charge.
There is a lot of neuroscience behind using actual visual images (The Emotional Life of Your Brain, Richard Davidson, 2012) but in addition the client and therapist have a shared experience by looking at pictures. Looking at pictures utilizes the optic nerve that creates micro saccades to maintain focus. People often pick several pictures and move their eyes between them EMDR style whilst focusing on disturbing body sensations. SUDs come down very rapidly. I’ve often thought they come down to quickly, but will need to reconsider this after reading about the Flash Technique.
I’d suggest not worrying about feeder memories. Work with whatever the patient freely offers up. When the SUDs on that memory is reduced, deeper and more threatening material will be released into conscious awareness for processing. Just keep on processing whatever comes up and that will automatically move you towards the core feeder.
It’s great that such a simple technique can completely replace the more complex EMDR. In essence we are talking about re-association, so it’s not new, but the speed component is a great breakthrough.
I am skeptical about those suggestions/assertions. In my experience, feeder memories often disrupt or block trauma processing, whether with standard EMDR/PC or with flash. Why wouldn’t we worry about them? Also who says that such a simple technique can completely replace EMDR? Nobody I’ve met. These are speculations only.
I don’t think we need to worry about feeders initially because whatever is suppressed will remain suppressed until the patient senses some degree of success and safety with the treatment of less threatening material. We provide an example of success, and the patient automatically releases more threatening material until we get to the core/feeder memory.
To go straight to the feeder is too threatening, imo. When something is too threatening, you get a lock down, dissociation or abreaction.
If going straight to the feeder would be too threatening in a given situation, there are alternatives. I don’t think that going to the later “fed” memory is a good choice, because of the feeder memory’s possible influence. We get a lot of refugees from other therapists who worked that way; the clients get overwhelmed/triggered and drop out of treatment. This is an important clinical question/strategy that we can argue, but that ultimately should be researched.
Is there a risk of misuse to be avoided; as when through a ‘therapist’s’ bias perhaps, a necessary healing engagement and resolution of an outcome effected by a client’s behavioral pathology (BPD, narcissism? ), is arbitrarily circumvented?
I’ve learned more useful stuff from this blog post reply thread than I did in three years of grad school, during which I cited several of the participants in most of the papers I wrote.
I’m new at PC and have recently begun using flash. During PC we run through “movies” of traumatic experiences in a finite amount of time, regardless of the movie’s real time duration. Could Flash be an exaggeration of this? I wonder about time outside the physical world, such as during memory recall. Could the rules be that different?
Regardless of the mechanism, the results are a wonder to behold. My deepest thanks to all of you.