The Flash Technique (Manfield, Lovett, Engel, & Manfield, 2017) developed by Dr. Phil Manfield has shown that moving a memory is possible without directly activating a memory or directly reprocessing it. How it happens and what is exactly happening is still up for discussion (See Dr. Ricky Greenwald’s blog HERE, particularly in the discussion section). Nonetheless, I have combined a bunch of ideas and approaches that helps a wide range of clients, particularly, first responders, police officers, vets, victims of crime, and people with addictions. I have also used it to help stabilize someone’s addiction recovery when they find themselves substituting their addictions. It is more than possible that what I am suggesting has been done before but I have not heard of it yet.
I have been searching to find something that can help stabilize someone’s addiction either by stabilizing the symptoms of trauma or the addiction (as if they were separate) through targeting the “addiction memory” (Boening, 2001) as a trauma. What I have found by combining flash technique with Ego State Therapy and a solid conceptualization of addiction in an intensive format helps stabilize both trauma, dissociation, and addiction. I am in full agreement with Dr. Jamie Marich blog (2019) on EMDR 2.5 where a solid understanding of the EMDR protocol combined with various other trauma techniques like titration, pendulation, using fragments, body mapping, and body sensations are helpful in preparing clients for reprocessing, particularly in Phase 2 of EMDR. With that said, what the flash technique has shown me is that it offers something else, in combination with Ego State Therapy, mainly stabilization of the memory system, creates a common goal, and provides access and resources to the unconscious mind. I find that the case conceptualization is particularly important because it provides the rationale needed to stabilize and paired with Ego State Therapy it provides the structure of the psyche. Which can be an unknown to the client at this stage of treatment. The case conceptualization that Dr. Marich and I are producing currently is “Addiction as Dissociation.” You can see an overview HERE.
The flash technique offers these criteria before using it: (1) it is for high impact trauma/high SUDS and (2) be mindful of feeder memories. On the point of feeder memories, I find that this approach helps eliminate that issue to a large degree but you still need to rule out significant dissociation, bi-polar or mania, psychotic symptoms before performing the flash technique as you would in Phase 1 of EMDR.
To me, what the flash technique offers is different from standard resourcing, RDI, or traditional preparation skills like grounding and is more like titration and pendulation.
Standard EMDR preparation skills like safe/calm place, container, healing light, or butterfly hug do not require accessing or activation of traumatic memories, however, it can happen with more complex presentations. From my understanding, titration and pendulation in the resourcing and preparation phase 2 is about working with painful material but in moderation. This is where preparation/resourcing 2.5 comes in to play. Dr. Marich’s point, besides that we should cautious of the latest fades, holds that because titration and pendulation do similar things to the flash technique. I fully agree because body awareness is powerful and allows the clients to gain experience holding the pain in their physical awareness. However, the flash technique does not require this. Titration and pendulation provide a “toe in the water” process, whereas the flash technique does not. However, clients still needs body awareness to reprocess so 2.5 skills will still have to be done as well before moving forward in the phases of EMDR and for EMDR to be the most effective.
There are some other aspects that the Flash Technique is different from standard resourcing, titration, and pendulation.
1) In Dr. Ricky Greenwald’s blog, and quoting Bruce Ecker in the discussion section, the flash technique may be taking out some of the fear of addressing the memory. I think this is where titration and pendulation are similar but direct contact with the overwhelming experience is not required in the flash technique.
2) By pairing the distressing memories with a positive place provides the opportunity for discord, which memory reconsolidation requires (Ecker, Ticic, & Hulley, 2012). Activation was also thought to be required in memory reconsolidation but this is what makes the flash technique different and possibly new.
3) Dual Attention Stimulus is used in Flash Technique and not typically in titration and pendulation.
4) Subliminal suggestions are powerful (just look at advertising) and when the memories are put on the back burner (possibly working memory) and a more positive experience is focused on, it appears that some shift in where the memory is stored is able to happen without activation. From my experience with this bulk format, when the more unconscious ego states are ready to let go of the pain of the traumas and have connected to the meeting area, they will let go. They feel more empowered to take on their stuff. Presentations where people are consciously or unconsciously bonded to their traumas, which are particularly in more shame-based presentation and developmental traumas, then memories are not going to move until there is cohesion in the ego state meeting area. However, the flash technique is not typically for these types of traumas and where titration and pendulation can be more helpful.
Where the flash technique is different is that it appears moves the memory… or memories as I found out about a year ago while working with a first responder and they said, “there are like 9 calls that stay with me still that are off the chart.” Ever curious, I thought about a bulk option.
What I am presenting here in the scripts below is an ideal and mostly general because each session is individual to the client. I do suggest consultation around this, particularly if is not clear. There is a level of finesse in this approach and it is not something that someone can teach per say because it is based on felt experience. This felt experience is based on the dual attunement that is critical to use as a guide. I have taught a handful of consultees this bulk technique,” who were first trained by Dr. Phil Manfield in the technique. “Bulk Flash,” as I am calling it, has gotten a similar response when they used it. I have done it with a dozen or so clients that I have used it and I am now offering it here to help others. For me, I have been using it to help first responders continue their work and to stabilize active addictions, which is quite promising.
Before you read further, you will need to know and feel comfortable with Ego State Therapy (or IFS), and the Theory of Structural Dissociation. I do not go into it too much here because it would be too much to cover. I do suggest Robin Shapiro’s Easy Ego State Interventions, Sandra Paulsen’s: When There are No Words and Looking Through the Eyes, Andrew Sheubert’s use of his RUG-C, Shirley Jean Schmidt’s: Development Needs and Meeting Strategy (DNMS), and Dissociation and Addiction Resources page with Institute for Creative Mindfulness: HERE.
Here is the set-up with some reasoning sprinkled in:
After the conscious intake, I do an unconscious intake by doing the dissociative meeting area based on Dissociative Table by Watkins and Watkins (1997) with every client. Whether it is metaphorical, analogous, or actual the ego state meeting area is a part of the clients lived experience one way or another, whether they are conscious of it or not. A main point of the meeting area is to see how conscious the client is of their unconscious process, let alone, how willing they are to go there. Another way of putting it is: the meeting area also helps see how willing the unconscious is to let them in.
What the ego state meeting area represents to me is a look into the psyche or “looking under the hood.” The aspects of self that present (and who don’t originally present) in the meeting area are what make this person, this person. The meeting area also allows them to see this aspect of themselves too, at least their conscious mind. This is a big moment for the conscious mind. This is how the “Eureka” moments work; the conscious aspects of the mind realizes what the unconscious has been saying all these years. The experiences and non-experiences alike that the client holds, have made them who they are today and I know that I am not only talking to the person that is sitting in front of me; I know that I am talking to every person they have ever been. Who they have been can hold the encapsulated memories (Scaer, 2010) of what happened to them. Or another way of saying it, they are personifications of those held traumatic experiences. All trauma impacts temporal time and space. Untreated trauma continues that trend to the point that the core beliefs and the emotion felt still stay with the person and is usually fragmented. However, as we know the body keeps the score. Trauma separates us because there was a before, during, and after a traumatic event so everyone who experiences trauma can feel a sense of separateness until it is resolved.
I offer this to clients: “I know that I am not only talking to the person that is sitting in front of me. I know that I am talking to every person you, you have ever been. I would like the yous that you have been to have opportunity to get the therapy that they did not get at the time.”
I then ask, “Where would be a comfortable place for you to meet who you have been?” “A meeting of the minds so to speak.”
This is a continuation of the assessment phase, meaning that I am looking to see how aware they are of their processes/who or what parts of them shows up. If and when there appears to be an understanding of the parts and their purpose (I use RUG-C or DNMS a lot here), I move forward by filling out the space by making it real with descriptions and see who shows up. If no one shows, then consider the broad spectrum of dissociation and do psycho-education and body awareness…)
I then ask, “Does it feel like any part of you is missing?”… “Or does it feel like there are parts that may be curious but are not ready to join quite yet?”
(If there are parts missing then suggest that this is the opportunity for them to listen, if they can and want to.)
I welcome any part that may be on the periphery to come in when they feel comfortable. Here I prepare to teach the container with psycho-education about the brain. For instance, the first five minutes of the movie Inside Out is extremely helpful here. I offer the clients and parts to fill the container (without eye movements for now) with the old memories that feel like they are still staying. I suggest that it is like a library, in such that there may be volumes of books or like a movie collection. I offer them to put any old tapes/movies of past experiences that they would like to put into the container, to put them there. I also offer around this time “that this is a space for the kids to be kids and adults to be adults.” Once everything is put away, I ask “is there any feeling that comes up as a result of having some separation from the bad experiences?” “Where do you feel it in your body?” (I will do a resource install or Brainspotting Resource Spot here, when appropriate). I then suggest that the client can put the container in waiting room like the flash technique offers. But before it is put away, I will then ask them (or really the conscious self), without opening any of them, “How many are there?” and then “How big are the volumes?” Just take note of them.
Then I set-up the flash/blink with a moment of joy and do the flash technique.
What I have found is that, after doing the first round of flash/blink, what was once 15 volumes are now 3-5 volumes and the parts that did not present earlier, start presenting more. I ask about body shifts and have them simply notice it. I do the flash technique again and check in with the meeting area to see what they might be noticing. I then have them check the volumes again. Usually it stays around 3-5 and the SUDS is significantly less. Clients also report that the volumes feel lighter, are smaller, and/or are more distant. They also report that the parts are lighter and more engaged. Sometimes the backdrop of the meeting area has lightened up, distance has been decreased, and more interaction is available. Utilizing Paulsen’s concept of building Ego strength, here is where to do it through relationship building and conflict resolution.
Some bullet points to consider from my experience of doing this so far...
1)This may become their “safe place.”
2)You may have to create a more separate work environment, suggested in the dissociative table were one can combine their efforts towards their treatment goals.
3)At some point, when appropriate, the future self/recovery self as a way of the client seeing what their long-term goals are, to increase motivation, and provide an adult to be present for the younger versions.
4)If the person is bonded or addicted to their traumatic memories, as Van der Kolk has suggested in several writings () there will be mixed emotions about letting things go. Utilize Motivational Interviewing with the parts. Understanding how addiction presents in mental health and how to treat it will help the client successfully complete treatment.
5)Borderline clients, from my experience, tend to avoid establishing the meeting area so more resourcing is needed to establish the meeting area.
6)I mostly do what I have presented here in a 4-hour intensive session.
Next, I will more than likely go into the Toxic Shame: Shape and Color Set-up that I have written about. See my blog post: HERE. I then do into their traumas in a chronological fashion, unless there is a reason not to. For addiction: I make sure that I targeted their “addiction memory” with the standard protocol with the one minor alteration as outline in a previous blog that I did. You can access it: HERE.
The long and short of it is that I find that once the inner children have the space to be kids, without the responsibility of being in charge of the outcomes of life, and they can trust the adult in charge, they tend to let go of their stuff without direct reprocessing. I do go back and check in on all of their memories over the course of treatment but often times now that they have their inner-children, they are good to go for a while. You still want to process all of the memories as Flash Technique suggests.
Complex PTSD is complex because of the dissociation profile involved (which includes addictions). I have found that this is a great start for clients to build off of because now clients have a conscious awareness of the psyche structure to work with and a conceptualization that validates their unconscious processes. This makes sense because when the unconscious separation and alienation that trauma causes becomes a conscious unified front, people feel more connected to their treatment goals and whole to their purpose in life. Taking the sting out of therapy with the flash technique helps clients start to put the memories where they need to be in order for adaptive mindset and lifestyle to take root.
EMDR Therapy Phase 2.5: Honoring a Wider Context for Enhanced Preparation by Jamie Marich, Ph.D., LPCC-S, LICDC-CS, REAT, RYT-200
As an EMDR educator, people are constantly asking me what I think of the latest trend in EMDR therapy. In the last year or so, Phillip Manfield’s Flash Technique has become all the rage. My students will tell you that I am not easily impressed by the latest spin on the standard protocol or twists on time-honored strategies for resourcing and regulating affect. I’ve long maintained that if you learn the standard protocol well and have a sense of how to mindfully modify with respect to special populations, dissociation, complex trauma, and the art of embodied resourcing, you have what you need. To be clear, I do not oppose use of the Flash Technique if it makes sense to the therapist using it and the technique helps the client. I also want to make my assessment clear that the Flash Technique, like many other trends that have captivated the attention of EMDR practitioners, is not a panacea or a quick fix. Indeed, it can prepare more complex clients for full reprocessing. Yet Flash is not the fullness of complete reprocessing and it is not a substitute for EMDR Phases 3-6. Indeed, there are many other strategies, especially from the tradition of embodied mindfulness, which can also engender more active preparation for reprocessing. Explaining my assessment of flash in this larger context led me and several colleagues on the Institute for Creative Mindfulness faculty to coin the term EMDR Phase 2.5.
Interventions that are more robust than traditional EMDR therapy preparation (Phase 2) that get a client fully ready to handle the affect that may emerge in Phases 3-6 belong in this critical middle ground. Many others and I have long taught that in working with complex trauma and indeed with most clients, doing one Calm Safe Place exercise is grossly insufficient. While the popularity of Resource Development and Installation or RDI (Korn & Leeds, 2002) and Resource Tapping (Parnell, 2008) inspired EMDR therapists to expand their scope on how to conceptualize preparation, many trauma-focused EMDR clinicians see that there are still other needs to be addressed. Namely, how do we help clients not just to stop, pause, or return to equilibrium when they abreact or when a session is due for closure; rather, how do we help prepare them for intensity? The intensity of affect release and shift that can help EMDR therapy to be so effective can also make it so scary for clients who have long been phobic of both affect and mindfulness.
This phobia of both affect and mindfulness develops as a legitimate response to unhealed trauma and dissociation (Forner, 2019), especially if a person was imprinted with negative cognitions such as: “I cannot show my emotions,” “It’s not safe to show my emotions,” “Showing emotions makes me weak,” among others (Marich, 2011; Marich & Dansiger, 2018). I’ve long taught trainees that even though their tendency may be to get nervous when a preparation skill like Calm Safe Place or container doesn’t seem to work, the client is still getting something valuable out of the exercise if you handle it well. These traditional preparation skills, if you follow the textbook, are supposed to bring about pleasant and resource-worthy experiences. Yet if they “go bad,” you now have an opportunity to guide a client through an experience in distress tolerance. For me, teaching a client that they can sit with unpleasant experiences for a time and/or use other resources to shift the focus is the best possible preparation skill that we can give clients in advance of moving into the reprocessing Phases (3-6) where discomfort will happen. For me, this is the essence of EMDR therapy Phase 2.5.
Our program and my approach to EMDR therapy is known for its focus on mindfulness. While Dr. Shapiro herself was a practitioner of mind-body healing modalities and studied with renowned west coast meditation teacher Stephen Levine, many EMDR therapists are not sufficiently grounded in the fundamentals of mindfulness and embodiment. Having these fundamentals is just as important, if not more important, than knowing an advanced preparation technique like Flash. Especially because Flash is not full-proof; many students and consultants have reported to us that it can “go bad” or open up into full reprocessing before a client is ready. As my colleague Dr. Stephen Dansiger and I explain in our 2018 book EMDR Therapy and Mindfulness for Trauma-Focused Care, the standard EMDR protocol is filled with invitations to mindful awareness. Use of questions like what are you noticing now? (Phase 4), when you scan your body from head-to-toe, what are you noticing? (Phase 6) and prompts like Go with that give us all the evidence we need that Shapiro developed EMDR therapy in a mindfulness context. Often defined as the practice of coming back to non-judgmental awareness, many have posited that mindfulness is one of the potential mechanisms of action in EMDR’s success (Logie, 2014; Shapiro, 2018). Yet if the first time a client is asked to be mindful or embodied is during their first run through the protocol, it may be too late.
As Christine Forner (2019) explains in her brilliant new article on connections between dissociation and mindfulness, dissociation is essentially a state of missing mindfulness. Mindfulness is about connection and dissociation is about surviving disconnection. Thus, many individuals who have spent their entire lives dissociating are literally phobic of mindfulness, and in the standard EMDR protocol we are asking them to be both mindful and embodied. This request is not necessarily a bad thing because learning to be mindful and processing mindfully is a major component of what can help us heal. As EMDR practitioners, we must do a better job of preparing clients for what the standard protocol expects.
Mindful and embodied EMDR therapy preparation requires more than just reading a script out of a book on mindfulness or showing a client a video. While I make several video resources in this area available online, I urge that EMDR practitioners must have a personal grounding in mindful and embodied practices to help clients deal with difficulties when the scripts don’t flow as planned for the client. Complex trauma and dissociation is messy and while we can do our best to give you a step list of what to follow for teaching these skills, drawing from your own personal experiences will help you to respond in the moment and guide clients through distress tolerance as safely as possible. In the Institute for Creative Mindfulness curriculum, we teach trainees to offer skills in all of these areas as part of Phase 2 preparation:
While we are not alone as a training program in teaching this widened scope, we see active exploration of these resources and the problems that they can bring up for the client as real opportunities to work with distress tolerance and engage in EMDR Phase 2.5. If a skill “goes bad,” we work with it to help a person notice the affect it creates or return to the present moment from any shut down that it caused. If a client protests, “I can’t do it,” we ask them how we might be able to modify a skill, which can include shortening the length of time that we spend in a skill.
A particularly strong skill from the mindfulness tradition that, in my view, should be taught by every EMDR therapist as part of EMDR Phase 2.5 is Mindfulness of Feeling Tone. Mindfulness of Feeling Tone is the second of four primary foundations of mindfulness. In this meditation, we ask the client to bring up their present-moment experience, scan the body briefly, and ask them if what they are noticing is pleasant, unpleasant, or neutral. Too often we have to orient clients to the language of what are you noticing now and if you’re doing it once they are activated in Phases 3-4, it’s too late. Many of our clients lack the vocabulary and practice with feeling or sensation to begin to even answer this question. This exercise is an elementary yet vital start to the process for it gives them three words to start with that are similar to the EMDR therapy constructs of adaptive, maladaptive, and neutral. You can take Mindfulness of Feeling Tone a step further by deliberately asking a client to bring up some association they would describe as pleasant and then guide them through noticing how they experience pleasant in the body. Do the same thing for unpleasant, which will be more challenging, yet ultimately more preparatory for what is to come in later Phases of EMDR Therapy. They don’t have to sit with the unpleasant experience forever; thirty seconds may suffice. Then you can move on to neutral and if needed, shift back to pleasant, strengthening that adaptive resource with DAS/BLS if appropriate. To watch a video demonstration of me guiding this exercise, please click HERE.
A resource such as Mindfulness of Feeling Tone is similar to the processes of titration and pendulation that Peter Levine actively calls upon in his creation, Somatic Experiencing®. I’ve trained many individuals well-schooled in both Somatic Experiencing and Sensorimotor Psychotherapy® and indeed one of the biggest criticisms they have of EMDR therapy is that we can blast a client in too quickly to the heart of the trauma without easing them into it using processes like titration and pendulation. Titration calls for a slowing down and only working on small pieces of a trauma at a time and then retreating into resources. While this process may go against what many EMDR therapists believe, stringently following Shapiro’s (2018) teaching that “preparation is not processing,” (p.36) I argue that for some complex clients titration is warranted. To me, this is where the Flash Technique is filling a gap in enhanced EMDR therapy preparation. For many years I have addressed this gap, if it appears with a client, by asking them what part of a target memory are they willing to work on first, even if it’s not necessarily the image or worst part. If needed, in the spirit of titration, we retreat into resources and then go back into this gentle test of processing. Sometimes the process of going with what we set up leads us to the worst part, other times it does not and we have to go back and set up the target again to address the worst image or worst part. My modification is another example of an EMDR Phase 2.5 that can lead into full Phase 3-4 that may be appropriate for complex clients. Yet in and of itself, the modification would be incomplete for optimal resolution of the memory.
The Flash Technique also seems to be helpful in the process of pendulation. Levine describes pendulation as the shifting of body sensations or emotions between those of expansion and those of contraction (Levine, 1997; Payne, Levine, &Crane-Godreau, 2015). A key principle of pendulation as practiced in Somatic Experiencing® is that a resilient nervous system is one that can move back and forth between alertness/action and calm/rest without getting caught in the extremes. Pendulation invites a fluctuation between resourced states and activated states as a mechanism for training our nervous system, which can help with long-term integration.
The Flash Technique, as described in this wonderful review by Ricky Greenwald (2017) (click HERE for the link), resonates for me as a practice of pendulation. This makes the Flash Technique a more robust form of EMDR preparation and thus meets my classification of it as EMDR Phase 2.5. I have long felt that EMDR therapists have much we can learn and integrate from Somatic Experiencing® and Sensorimotor Psychotherapy® and I believe that Manfield has given us a way to bring in some of these ideas, especially through the visual channel.
However, Flash Technique is not the only way to prepare our clients more effectively for the intense affect and embodied shifts that will inevitably happen once EMDR Phases 3-6 commence. Some of the mindfulness and embodiment skills that I covered in this article are a mere overview of what EMDR therapists can learn to more effectively prepare clients. I’ve long admired that the flexibility of EMDR therapy Phase 2 allows practitioners to bring in other modalities or approaches that they feel can strengthen the skills a client acquires in preparation. On my team, in addition to traditional mindfulness work, my faculty members and I make use of yoga, dialectical behavior therapy, expressive arts therapy, 12-step strategies, well-established work like Seeking Safety®, and creative interventions offered to us by other leaders in the EMDR therapy community like Jim Knipe and Ana Gomez.
All of these strategies are available to you and to your clients! Learning them and implementing may not feel as simple as reading a script or following a simple set of steps. I know that many EMDR therapists want these steps spelled out and this is natural for adult learners. However, it seems that every few years I talk to therapists who get caught up in the latest trend without learning the context that surrounds it and this is problematic. Even more problematic is if practitioners believe that the latest thing will replace their need to do other, more comprehensive resourcing. There are no short cuts in EMDR therapy; it takes hard work and personal commitment to become fluent and responsive. Committing to the expansion of your skill set using some of the other strategies we described here and your own personal practice with many of these skills means that you will excel at working in EMDR Phase 2.5!
Please, let’s make this an active blog. Share in your comments if this “2.5” concept resonates with you and what you have done to foster this level of preparation other than using the Flash Technique. I look forward to hearing from you.
Special thanks to Institute for Creative Mindfulness team members Amber Stiles-Bodnar, Dr. Stephen Dansiger, Suzanne Rutti, Adam O’Brien, Ramona Skriiko and several others for their contributions to this piece.
Forner, C. (2019). What mindfulness can learn from dissociation and dissociation can learn from mindfulness. Journal of Trauma & Dissociation, 20(1), 1-15.
Greenwald, R. (2017). Flash! Trauma therapy just got easier and faster. Trauma Institute & Child Trauma Institute Blog. 28 November 2017, available at www.childtrauma.com/blog/flash/
Korn, D., & Leeds, A. (2002). Preliminary evidence of efficacy for EMDR resource development and installation in the stabilization phase of treatment of complex post traumatic stress disorder. Journal of Clinical Psychology, 58, 1465–1487.
Levine, P. (1997). Waking the tiger: Healing trauma. Berkeley, CA: North Atlantic Books.
Logie, R. (2014). EMDR- more than just a therapy for PTSD? The Psychologist- The British Psychologist Society, 27 (512-517).
Marich, J. (2011). EMDR made simple: Four approaches to using EMDR with every client. PESI Publishing (Premiere): Eau Claire, WI.
Marich, J. & Dansiger, S. (2018). EMDR therapy & mindfulness for trauma-focused care. New York: Springer Publishing Company.
Parnell, L. (2008). Tapping in: A step-by-step guide to activating your healing resources through bilateral stimulation. Boulder, CO: Sounds True Books.
Payne, P., Levine, P., & Crane-Godreau, M. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 4 February 2015, DOI: https://doi.org/10.3389/fpsyg.2015.00093
Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing: Basic principles, protocols, and procedures, 3rd ed.New York: The Guilford Press.
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