The Flash Technique is a new protocol for use in the preparation phase of eye movement desensitization and reprocessing (EMDR) to quickly reduce the emotional intensity of traumatic memories, prior to full processing with EMDR. This report presents results from a Flash Technique group for five highly dissociative, currently sober addicts in a men's shelter. This group was an attempt to provide an affordable, trauma-focused intervention for the homeless. As part of the intake, each client met individually with the therapist for 30 minutes, to learn to use the flash technique to process a traumatic memory. Three inventories were used to measure treatment outcome: the Short PTSD Rating Interview (SPRINT), the Dissociative Experience Survey (DES-II), and the Beck Depression Inventory-II (BDI-II). Clients filled out the surveys 3 weeks before the start of the group and had their individual sessions 2 weeks before the start of the group. The DES and BDI-II were repeated at the beginning of the eighth session of the group. Clients' surveys showed a decline in scores after seven sessions of therapy: the DES scores dropped from 39.07 (standard deviation [SD] = 23.01) to 20.48 (SD = 10.02) with d = 0.81 and the BDI-II scores dropped from 32.4 (SD = 11.01) to 13.2 (SD = 8.4) with d = 1.74. Pre- and 2-week posttreatment SPRINT surveys showed scores dropping from 28 [SD = 2.05] pretreatment to 15.75 [SD = 5.19] 2 weeks posttreatment, with d = 6.07.
Research has shown that the Flash Technique (FT) appears to reduce memory-related disturbance and may reduce symptoms of posttraumatic stress disorder. This paper discusses the connections between FT and eye movement desensitization and reprocessing (EMDR) therapy. In FT, clients remind themselves of a traumatic memory without dwelling on it and focus instead on a positive engaging focus and then blink their eyes when prompted. This paper summarizes numerous models describing how the brain processes traumatic material and presents a model for how FT may work in the brain. It proposes that during the blinking, the patient's periaqueductal gray (PAG) may take over, sensing the reminder of the traumatic memory and reflexively triggering the amygdala. In Porges's neuroception model, the PAG assesses danger without going through the conscious brain. Recent fMRI data show that for patients with posttraumatic stress disorder, there is enhanced connectivity from the amygdala to the left hippocampus. Thus, triggering the amygdala may, in turn, activate the left hippocampus, which may then provide a brief access to the traumatic memory. Given the brief access, there is insufficient time for the amygdala to go into overactivation. The client remains calm while accessing the traumatic memory, thus setting up the prediction error necessary for possible memory reconsolidation. This process is repeated during blinking in FT allowing memory reconsolidation to proceed. This model requires experimental confirmation.
This case study investigated the effects of an eye movement desensitization and reprocessing (EMDR)-based divorce recovery group, consisting of four modalities: (a) modified EMDR Integrative Group Treatment Protocol adapted for adolescents and adults living with ongoing traumatic stress (EMDR-IGTP-OTS) to deal with the trauma from the divorce, (b) modified Affect Circuit Reset protocol to reduce intensity of negative affects, (c) psychoeducation on affects and divorce-related issues, and (d) small group discussion. The divorce recovery program is an attempt to provide an affordable, trauma-focused intervention for divorce recovery for low-income populations. This report summarizes the outcomes in a divorce recovery group of six women, all Chinese immigrants. Aside from one person in the midst of divorce, the group consisted of individuals divorced for 7 years or more, for whom the distress had lasted more than the 2 to 3 years typical of divorce recovery. Short Post-Traumatic Stress Disorder (PTSD) Rating Interview (SPRINT) scores collected at the beginning of week 2, at the end of week 7, and at the beginning of week 8 showed PTSD symptoms dropping from severe to mild. The mean SPRINT scores at 6 weeks and 13 weeks after treatment continued to decrease, approaching the no/minimal symptom range. The SPRINT scores showed a 65.6% reduction between week 2 (18.0 [SD = 8.4]) and 13 weeks after treatment (6.2 [SD= 5.5]), with a large effect size of d = 1.40, and a significant decrease of t(4)=4.0, p = .016.
This article presents a model for understanding how the Flash Technique (FT) may work in the brain and provides potential avenues for experimental confirmation. In the FT, the client reminds himself of a traumatic memory without dwelling on it but instead focuses on a positive engaging focus and then blinks his eyes as prompted by the therapist. Clients have reported signs of memory reconsolidation, for example, the memory getting blurry and a reduction in emotional response. While the originators of FT did not offer a detailed mechanism for FT, this article proposes that during the blinking, the patient’s periaqueductal gray (PAG) takes over, senses the reminder of the traumatic memory and reflexively triggers the amygdala. As part of a system suggested by Porges (2009) for neuroception, the PAG works reflexively to assess danger without going through the conscious brain. Recent fMRI data show that for posttraumatic stress disorder (PTSD) patients, there is enhanced connectivity from the amygdala to the left hippocampus. As a result, triggering the amygdala may, in turn, activate the left hippocampus, which may then provide a brief access to the traumatic memory. Given the brief access, there is not enough time for the amygdala to go into overactivation. The client remains calm while accessing the traumatic memory, thus setting up the prediction error necessary for memory reconsolidation. This process is repeated many times during blinking in FT to allow memory reconsolidation to proceed, in some cases, to completion. This model is open to experimental confirmation.
There are not enough psychotherapists to offer individual trauma intervention to the tens of millions of people traumatized around the world. Eye movement desensitization and reprocessing (EMDR) is a proven trauma treatment but requires substantial time and financial resources for training. One solution may be low-intensity intervention with the flash technique (FT) offered one-on-one online and based on highly scripted instructions in which participants can work on their distressing memories independently. The FT is a protocol that was originally developed for the preparation phase of EMDR and only requires a few hours of training. In this study, we aim to explore whether a scripted FT protocol used by inexperienced student clinicians might be effective. Nine master-level social work students, trained in FT and under licensed supervision, offered individual FT treatment online using a scripted protocol. Participants were admitted to the study with an Impact of Event Scale—Revised (IES-R) score of >24. Pre- and posttreatment surveys were collected from 30 participants who each received 6 sessions of individual therapy. No follow-up study data was collected. The IES-R data dropped from a pretreatment mean of 45.97 (SD= 14.5, 95% CI = [40.78, 51.16]) to posttreatment mean of 25.33 (SD= 14.92, 95% CI = [19.99, 30.67]), with ap-value of <.00001 and a Cohen’sd= 1.4, showed a large effect size. Interpretation of the study results is limited due to a lack of a control group and a relatively small sample size (n= 30). Furthermore, since we did not follow participants posttreatment, the impact of the intervention over time is unknown for this study. Even so, the data suggested that the scripted FT protocol might be usable even by inexperienced student clinicians, paving the way for its use as a low-intensity trauma intervention.
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