Over the course of several months, training notices for the Flash Technique (Manfield et al., 2016) arrived in my email several times, before curiosity compelled me to attend the online training in February 2020. I was instantaneously hooked and began using it with my child clients. The advanced online trainings in June 2020 and March 2021, provided me with additional techniques that were helpful in working with Complex Trauma/Dissociation. Dr. Mansfield and Dr. Engel incorporate humor, practical application, and simplicity into their training and treatment techniques.
The Flash Technique is an Eye Movement Desensitization Reprocessing (Shapiro, 1995) Protocol. Over the course of time, Dr. Manfield hypothesized three phenomena:
- “Unreportable” (subliminal) processing, bypassing conscious defenses
- Modified memory reconsolidation
- Cultivation of a present observer position, rather than reexperiencing” (2020).
In my simple thinking, I conceptualized these phenomena as less might be better!
The protocol is short and easy. The client chooses a target and rates the severity of their distress on the Subjective Unit of Distress Scale (SUDS), where zero means no distress and 10 is the highest possible distress. The client chooses a Positive Engaging Focus (PEF) (Manfield, 2020). which can be an event, activity, animal, music, play or anything that is completely positive for the client. Bi-lateral Stimulation (BLS) can be achieved with pulsers or tapping. During activation of the PEF, the therapist says, “Flash” and the client rapidly blinks three times without thinking of the target. A set consists of three rapid blinks, five times. Following 2-3 sets, the client is asked what is different. The process is repeated until the SUDS level is zero. Several recent articles describe the clinical application of Flash technique for people with dissociative disorders more fully (Shebini, 2019; Wong, 2019).
This article purposes to share combined techniques that I have found beneficial for children with and without Dissociative Disorders. I work primarily with adoptive families. I especially love working with early childhood age children, as well as adolescents. I recently started incorporating Play Therapies and Animal Assisted Interventions with the Flash Technique to make it even more fun for children. The use of the sand tray, painting, drawing, and puppets allows the child to express the PEF non-verbally. The child can also narrate while creating the PEF or engage in detailed conversation if it is about an event. Boaz, my therapy dog, who is 97 pounds of love, serves as a living PEF! The child pets, draws and/or hugs Boaz while describing the aspects that the child loves about him. His drooling in anticipation of treats, roll-over for belly rubs, as well as his happy sneezes frequently evoke laughter. The child has a choice between pulsers, also call buzzies or buzzers to place in their pants pockets or me tapping on their knees or shoulders with a magic butterfly wand, puppet, etc., so little hands are free to play! In joint parent/child sessions, I ask if the child would like the parent to apply the BLS.
Often, by the time parents make the initial contact with a me, their child’s extreme emotional dysregulation has long erupted into verbal and physical aggression. Some of these children have had previous short and long-term therapy with little or no success. I find that an article “When Treatment Fails and Why” (Waters, 2005) is an excellent resource for parents in this situation. Parents feel unable to manage their child’s rapid state changes and are confused about the ineffectiveness of the trauma parenting techniques they were taught during the adoption process. This adds their feelings of inadequacy, anger, resentment, and desperation. As much as they desire to do so, these dear parents are unable to provide the physical and psychological safety that they know their child needs (Waters, 2016, p. 135). In such cases, stabilization is urgently needed to create a safer environment for clients, their peers, and/or family members. I have found that the Flash Technique can be safely implemented in the first few sessions after the parts of self have been identified. The process is painless, effective, and remarkably quick.
For children without Dissociative Disorders, I often implement the Flash Technique in the child’s first session. I guide the child in creating a Worry Map, Hard Stuff or Problems to Solve Lists. The child rates the level of severity using the SUDS. We target that which has the highest rating with the Flash Technique and usually completely resolve the issue within 5-10 minutes. Parents report that during the following week, they see progress in the area that was addressed in the first session.
The use of the Flash Technique with children who have Dissociative Disorders has been helpful in the Stabilization Phase. The reduction of triggered responses in the first few sessions gives parents the much-needed hope that their lives will be more of what they envisioned when they entered the adoption process. Children learn that they can make their internal world a better place and begin to more fully enjoy the world around them.
In the following vignette, all identifying information has been changed and permission was granted by the client and family for use in this article.
The parents disclosed details of Jamey’s early history during the parent-only intake session. In summary, Jamey was born with chemical dependency and in detox treatment for the first 3 months. He suffered from malnutrition and numerous physical ailments. He was neglected by his birth mother, who would often put him in a dark closet and play loud rock and roll music to mask his crying. This continued for the first 10 months, after which he was passed off to various family members and caregivers, until his adoption at 19 months of age, by Nick and Jean.
Nick and Jean had grown up in stabile, healthy family environments and were successful entrepreneurs. They were very active in their community and church. Nick and Jean immediately made Jamey the center of their lives. Extended family members lovingly welcomed Jamey into the family, and fully supported the new parents. Nick and Jean, however, were not prepared for what ensued and white-knuckled their way through the following seven years. They used the various techniques, approaches, and activities they were previously taught, with minimal effectiveness. When they came to see me, they were exhausted and reported that Jamey had destroyed their furniture during rages and multiple episodes of intense, high energy. Jamey had also been pulled from public school because of his disruptive behaviors.
Jamey came in for his first session, shortly after his ninth birthday. He identified his parts of self, their roles, and places each lived in his body during the first two sessions. He was quite insightful, articulate, and creative as he described his internal world. Dissociative children can find solace in creating an internal world to manage trauma, to feel powerful, and create a sense of normalcy by incorporating the outside world in the internal world. Jamey reported that the Zombies Family mainly stay in their dilapidated house and the Crocodile holds very sad emotions about a more recent family tragedy. The Lion becomes angry when he perceives that someone is making fun of or bullying Jamey. Also, when the Lion hears loud sounds, he gets really angry and fireworks go off inside. The Dragon hates loud sounds, too. He and the Lion really like waterfalls, because those eventually put out the fireworks; however, Jamey’s parents reported that Jamie’s destabilization episodes can last several hours.
I decided to use the waterfall image to facilitate stabilization with Jamie. I had just enough time remaining in the second session to add BLS to the waterfall image adding sensory experiences for enhancement so that Jamey could use it as a resource (Shapiro, 1995, Phase Two). I modeled various ways of tapping it in, some more subtle, if he needed to use it in public places.
In the third session Jamey reported that the Dragon had a hard time with loud sounds too and described a recent incident when that had occurred. He and the Dragon rated it at 8 on the SUDS. I demonstrated the Flash Technique with Jamey, then asked if he and all parts wanted to try it. They agreed and chose to stay close to the Dragon to help him. Jamey selected the speed/intensity of the buzzies and placed one in his right pants pocket and the other in the left. His PEF was a recent family vacation, which he created in the sand tray. In 2-3 sets, Jamey reported a SUDS level of one and all the parts were feeling better too, because they were standing so close to the Dragon.
Jamey reported in his fourth session, that the Lion was having problems because he was so nervous about an upcoming meeting at the bank where he worked. We targeted the Lion’s nervousness, which he rated as eight on the SUDS. All parts agreed to support the Lion by remaining near him. Jamey’s PEF was a waterfall that he created in the sand tray simply by repeatedly pouring the sand over his hand. I turned on the pulsers that Jamey had placed in his pants pockets and after only one set, Jamey reported a zero on the SUDS!
The following week, Jamey stated that the Lion did really well in his meeting. The buzzies helped the Lion so much that he was able to go help the Dragon at his workplace, the coffee shop! The Lion and the Dragon also started swapping jobs, when their bosses said it was OK. The Dragon especially appreciated the Lion’s help when the coffee shop was really busy. The Lion liked working at the coffee shop, because it was so different than his job at the bank. The Lion has successfully participated in several subsequent meetings at the bank without feeling nervous.
In the next parent meeting, Nick and Jean reported progress. Jamey’s rages were less intense, shorter in duration, and less frequent. They had also implemented the specialized parenting techniques I suggested (Waters, 1998), with some success. The parents were so encouraged that they requested bi-weekly sessions to accelerate the progress. I transitioned Jamey to another energy healing modality that has also been helpful and in two weeks we achieved full stabilization. Regularly-scheduled sessions were reduced to once a week and to date, he continues to make notable progress with partial integration.
The children I work with love the Flash Technique, because they feel better so quickly and have fun in the process. It empowers them as they experience emotional regulation in areas that previously evoked strong, emotional dysregulation. I believe that their active role of making choices of which PEF, BLS, and activities also builds a sense of mastery. Boaz is quite fond of the Flash Technique, too, as he enjoys being a frequent PEF! Although, I have tried incorporating other Play Therapy activities, so far, the sand tray is the most popular. The combination of Play Therapy, Animal-Assisted Interventions, and the Flash Technique is a good fit for me, too. It does seem like less might be better!
Note from the author: Thank you for reading my article and I welcome your feedback, comments, and constructive criticism. Please feel free to contact me directly: michele@liberatedlivingforyou.com
References
Manfield, P., Lovett, J., Engel, L., & Manfield, D.(2016). What is the flash technique in EMDR therapy? Retrieved from: https://www.serenityoakswellness.com/blog/what-is-the-flash-technique-in-emdr-therapy, June 18, 2021
Manfield, P., Lovett, J., Engel, L., & Manfield, D. (2017). Use of the Flash technique in EMDR therapy: Four case examples. Journal of EMDR Practice and Research, 11, 195-205.
Manfield, P., Engel, L. (2020) Memory Reconsolidation, the Flash Technique and EMDR, Webinar Training
Shebini, N, (2019). Flash technique for safe desensitization of memories and fusion of parts in DID: Modifications and resourcing strategies. Frontiers of the Psychotherapy of Trauma and Dissociation, 3, 151-164.
Silberg, J.L. (1998) The Dissociative Child: Diagnosis, Treatment, and Management, (2nd Edn), Baltimore, MD, Sidran Institute Press.
Waters, F.S. (1996). “Parents as partners in the treatment of dissociative children.” In J.L. Silberg (Ed.), The Dissociative Child: Diagnosis, Treatment and Management, Lutherville, MD. Sidran Press.
Waters, F. (2005). When treatment fails and why. Journal of Trauma & Dissociation, Vol. 6(1) http://www.haworthpress.com/web/JTD. © 2005 by The Haworth Press, Inc. All rights reserved. Digital Object Identifier: 10.1300/J229v06n01_01 1
Waters, F. S. (2016). Healing the fractured child: diagnosis and treatment of youth with dissociation. New York: Springer Publishing Company.
Wong, Sik-Lam. (2019). Flash technique group protocol for highly dissociative clients in a homeless shelter: A clinical report. Journal of EMDR Practice and Research, 13, 20-31. 195-205.
Other Helpful Resources
Boik, B., Goodwin, E. (2000). Sand play therapy. New York: W.W. Norton and Company, Inc.
Manfield, P., Lovett, J., Engel, L., & Manfield, D. (2017). Use of the Flash technique in EMDR therapy: Four case examples. Journal of EMDR Practice and Research, 11, 195-205.
Silberg, J. (2013). The child survivor. New York: Routledge