Flash technique

1. Introduction

Version followed: the triple-blink Flash Technique (FT) as set out by Manfield, Engel, Greenwald & Bullard (2021, Journal of EMDR Practice and Research 15(2)), with the EMDR-integration rules described by UK trainer Justin Havens (2020, 2026). Where they differ, the original "flash to the memory" version (Manfield, Lovett, Engel & Manfield, 2017, v1.0) and named adaptations (Wong 2019; Gustavson, Wong & Le 2023; Yarberry 2021 for children) are labelled. The full 2017 paper and the book-length manual are not drawn on [uncertain].

The Flash Technique was developed by Philip Manfield (San Francisco Bay Area) and colleagues. It started as a technique for the preparation phase (Phase 2) of EMDR therapy. It reduces the disturbance of a traumatic memory before standard processing, and it is now also used on its own or alongside other trauma therapies [source: Manfield et al. 2017 abstract; Manfield et al. 2021; Howes/Manfield interview 2023]. It grew out of Krystyna Kinowski's "Put Your Best Foot Forward" and Manfield's "paired titration" [source: Howes 2023].

Core idea of change (as the developers hold it): the client identifies a disturbing memory but does not hold it in mind. Instead they attend to a positive or engaging focus, and on a cue they blink rapidly a few times. Manfield proposes three things: the memory is accessed below the level of conscious disturbance; fight-or-flight activation, which he holds impairs processing, is avoided; and blinking briefly reconnects working memory to the memory so that memory reconsolidation can take place. Manfield himself says this mechanism is not established [source: Howes 2023; Wong 2021 working-memory model; Yarberry 2021 summarising Manfield 2020]. Clients typically report that the memory seems "further away," fuzzier or harder to access [source: Manfield et al. 2021; Howes 2023].

FT is a brief technique, not a complete therapy. Manfield is quoted saying it "isn't a replacement for therapy" [source: Howes 2023]. Havens calls it an enhancement to EMDR, not a replacement [source: Havens 2020, 2026].

2. Framework

FT has no multi-phase course of its own. It is a procedure inserted into a wider trauma treatment, most often EMDR's 8 phases. The usual sequence:

Within one FT round (Manfield et al. 2021 version):

1. Identify the target and estimate its SUD without feeling it.
2. Set up and intensify the Positive Engaging Focus (PEF).
3. Bilateral tapping.
4. About six cued triple-blink "flashes" (other versions use five).
5. A light check-in.
6. Repeat while the disturbance keeps falling. Take a formal SUD only once it seems substantially reduced.

The 2021 webinar version: 30 min psychoeducation, then two 15-min FT rounds, each with a pre and post SUD.

Other published formats:

• Lab analogue: an 8-minute online session (Brouwers et al. 2021).
• Low-intensity student-clinician version: six weekly 30–45-min Zoom sessions of seven blocks of five triple-blinks, up to six memories in total (Gustavson et al. 2023).
• Group for highly dissociative shelter residents: a 30-min individual training session 2 weeks before, then group sessions for at least 7 weeks (Wong 2019).
• Two 120-min group sessions on consecutive days: Konuk 2021, reported by Wong 2021. Details [uncertain].

Goal of a round: in EMDR preparation the aim is reduction, not zero. Havens notes that even a 2–3 point SUD drop can be worthwhile in a 10-minute intervention [source: Havens 2020, 2026]. In low-intensity settings the aim is symptom relief [source: Gustavson et al. 2023].

Readiness criteria. The sources say little here:

• Published: the 2021 webinar discouraged people who did not think they were psychologically stable or who had poor affect-modulation skills [source: Manfield et al. 2021]. FT was originally developed to titrate memories for clients with complex PTSD and dissociation, where standard EMDR risks flooding, so dissociation is not in itself an exclusion [source: Manfield et al. 2021; Wong 2019].
• Added [synthesis]:
  • Screen for dissociation (e.g. DES-II, as Wong used for outcome).
  • Assess current suicide risk with standard practice.
  • Check for active psychosis and current intoxication.
  • Confirm the client can use at least one grounding skill before the first round.
  • With highly dissociative clients, follow phase-oriented ISSTD-style stabilisation and map parts before targeting.

3. Guiding principles

• Minimal conscious activation. The client does not picture, describe or feel the memory; they "touch it lightly" and set it aside [source: Howes 2023; Manfield et al. 2021]. Practice: if the client starts going into the memory, steer them back to the engaging focus.
• Engagement over exposure. The PEF has to be genuinely engaging, positive or simply absorbing (conversation counts) [source: Manfield et al. 2021; Havens 2020; Wong 2021]. Practice: a weak PEF is the first thing to fix when nothing changes.
• Titration. FT is a dosing tool: brief, sub-threshold contact repeated many times [source: Howes 2023; Manfield et al. 2017 abstract]. Practice: use it whenever a target is too hot to approach directly.
• Enhancement, not replacement. FT sits inside a treatment plan [source: Havens 2020, 2026; Howes 2023]. Practice: after FT, continue with full reprocessing or your main therapy; do not discharge on one FT session.
• Precision. Havens warns that FT is often misused or done imprecisely, especially with intense memories [source: Havens 2026]. Practice: keep the step order (target, PEF, blinks, light check-in) and do not improvise exposure into it.
• Content need not be disclosed. FT can be done "blind to therapist" [source: Havens 2020, 2026; Howes 2023]. Practice: ask for a label ("the target"), not a narrative; this suits clients who avoid therapy because they fear telling.
• Reduction is success. A partial SUD drop counts [source: Havens 2026; Gustavson et al. 2023]. Practice: stop at a tolerable level and move to the standard protocol rather than chasing zero.
• Over-stabilisation is a risk too. Havens holds that processing is often the best stabilisation [source: Havens 2026]. Practice: use FT early to reduce load instead of extending resource work indefinitely, provided readiness criteria are met.
• Client choice and language sensitivity. Avoid the cue word "flash" with military veterans and survivors of childhood sexual abuse [source: Havens 2020]. Let clients choose BLS speed and intensity, and ask dissociative clients and all their parts whether they want to try [source: Yarberry 2021]. Practice: use "blink" as the cue when in doubt.
• Memory as the client's experience. FT works on the disturbance attached to a memory as the client reports it, not on establishing what happened [synthesis, in line with the domain rule]. Practice: never use FT, imagery or suggestion to uncover or "recover" memories.

4. Intervention inventory

Interventions 4.1–4.8 form the core individual procedure, in session order. 4.9–4.18 are variants and adaptations.

4.1 Introducing FT and obtaining consent

• Purpose / when: Before the first round, especially with clients who avoid trauma work because they fear having to talk about it, think about it or feel it [source: Havens 2026].
• Steps:
  1. Briefly explain that they will choose a memory, set it aside, focus on something enjoyable, and blink on cue.
  2. Tell them they will not need to describe or picture it.
  3. Explain what they may notice: the memory may seem further away or less vivid.
  4. Mention the possible effect on later recall (see Watch for).
  5. Ask for consent.
  6. With a dissociative client, demonstrate the method first, then ask whether they and all their parts want to try [source: Yarberry 2021].
  7. Do a practice set of blinks [source: Brouwers et al. 2021].
• Example language (illustrative): "We'll pick one memory that still bothers you. You won't need to tell me about it or picture it. You'll just know which one it is, then put it to one side while we talk about something you enjoy. Every so often I'll say 'blink' and you blink quickly three times. Afterwards some people find the memory feels further away. Shall we try a practice blink?"
• Watch for:
  • Expectancy pressure. Don't promise results.
  • Clients who may need to give evidence about the event. Some participants could not recall the processed memory at follow-up [source: Manfield et al. 2021], so discuss this before targeting events that are or may become subject to legal proceedings [synthesis].

4.2 Target identification ("touching it lightly")

• Purpose / when: Select the memory or image to work on.
• Steps:
  1. Help the client identify a disturbing memory or image, the "target." A label or codename is enough [source: Manfield et al. 2021; Howes 2023].
  2. Ask them to rate the SUD (0–10) the memory would produce if they let themselves feel it, without feeling it now [source: Manfield et al. 2021].
  3. If it is very hot (SUD 10), keep the contact to a fraction of a second [source: Havens 2026].
  4. If an earlier memory seems to feed the disturbance, target that earlier one first [source: Manfield et al. 2021].
  5. Optional: a timeline review ("run a video" of past events) to find targets; recent events are not required [source: Gustavson et al. 2023].
• Example language (illustrative): "Just touch the memory for a moment, like touching a hot pan and pulling away. If you let yourself feel it, how disturbing would it be, 0 to 10? Don't go into it to find out. Your best guess is fine."
• Watch for:
  • The client starting to narrate or re-experience. Interrupt gently and move to the PEF.
  • The SUD being given from inside a flooded state. Ground first (4.13).

4.3 Positive Engaging Focus (PEF): selection and intensification

• Purpose / when: The engine of FT. It holds attention away from the target.
• Steps:
  1. Ask for something that gives immediate pleasure or absorption, for example:
     • an activity, an animal, a person, a positive memory or a piece of music [source: Manfield et al. 2021];
     • funny videos, conversation about a personal interest, dancing or singing [source: Wong 2021; Gustavson et al. 2023];
     • a neutral focus such as slow breathing or a body scan [source: Gustavson et al. 2023].
  2. If needed, use actual music or engaging images [source: Manfield et al. 2021].
  3. Intensify it:
     • Ask the client to describe what they like about it [source: Manfield et al. 2021].
     • Ask them to call up sensory details [source: Brouwers et al. 2021].
     • Keep the conversation about it going during the blinks. Havens uses a "conversation engaging focus" such as a favourite TV programme [source: Havens 2020, 2026; Howes 2023].
  4. Optionally rate its pleasantness 0–10 [source: Brouwers et al. 2021].
• Example language (illustrative): "What's something that just makes you smile? … Your dog at the beach. Tell me what she does when she sees the water. What colour is she? What sound does she make?"
• Watch for:
  • Flat affect, short answers or the client drifting back to the target. These mean the PEF is too weak. Change it (4.8).
  • PEFs that are linked to the trauma, such as a person involved, or bittersweet ones, such as someone who has died. Choose another [synthesis].

4.4 Bilateral tapping (BLS)

• Purpose / when: Used during the PEF in the Manfield 2021 protocol [source: Manfield et al. 2021].
• Steps:
  1. The therapist taps alternate thighs and the client copies while holding the PEF. In webinars, participants slowly slapped their own thighs alternately.
  2. Alternatives: pulsers ("buzzies"), or tapping knees or shoulders with a wand or puppet for children [source: Yarberry 2021].
  3. Let the client choose the speed and intensity [source: Yarberry 2021].
• Example language (illustrative): "Copy me: slow taps, left, right, while you stay with the beach."
• Watch for:
  • Wong argues that tapping does not drive the effect, and some clients processed without it [source: Wong 2021]. Havens treats tapping and swaying as troubleshooting options, not core steps [source: Havens 2026]. Treat BLS as optional [uncertain: versions differ].
  • Touch by the therapist is not needed. Keep it client-administered [synthesis].

4.5 Triple-blink sets ("flash")

• Purpose / when: The active ingredient as the developers describe it.
• Steps:
  1. While the client stays engaged with the PEF, give the cue "flash" or "blink." The client blinks rapidly 3–5 times without deliberately thinking of the target [source: Manfield et al. 2021; Havens 2026; Gustavson et al. 2023]. The 2021 instruction reads: "blink your eyes rapidly three, four, or five times" [source: Manfield et al. 2021].
  2. Cue roughly every 5–6 seconds (webinar pacing) [source: Manfield et al. 2021].
  3. Give 6 cues per round (2021 webinar) or about 5 (Havens, Brouwers, Gustavson), then pause for a check-in. Yarberry describes five triple-blinks per set, with a check after 2–3 sets [source: Yarberry 2021].
  4. Keep the PEF conversation going between cues.
• Version note:
  • In v1.0 (2017) the client briefly "flashed" to the memory on the cue and came straight back [source: Wong 2021; Havens 2026].
  • Since Manfield & Engel 2018 the client simply blinks and does not go to the memory [source: Wong 2021; Havens 2020].
  • Use the current version unless you have a specific reason.
• Example language (illustrative): "…so he jumps right into the waves — blink — good, and then what does he do? — blink —"
• Watch for:
  • The client deliberately bringing up the memory on the blink. Remind them it's not needed.
  • Eye discomfort. Fewer blinks are fine [synthesis].

4.6 Light check-in

• Purpose / when: After each round of about 5–6 cues.
• Steps:
  1. Stop the PEF.
  2. Ask the client to check the target lightly, without thinking about it directly, and notice whether anything has changed. Don't measure it yet [source: Manfield et al. 2021].
  3. Ask a yes/no question rather than the EMDR "what are you getting now?" [source: Havens 2026].
  4. If the client struggles to describe a change, you may mention that for many people the memory seems further away [source: Manfield et al. 2021]. Use this sparingly, since it is a suggestion [synthesis].
• Example language (illustrative): "Let the beach go for a second. Just glance in the direction of the target, no need to look at it. Anything different? Yes or no is fine."
• Watch for: Typical changes are that the memory is further away, fuzzier, smaller or harder to find [source: Howes 2023]. These mean it is working.

4.7 SUD tracking and decision rules

• Purpose / when: To decide whether to continue, troubleshoot or switch to another method.
• Steps:
  1. Repeat the tapping, blink set and check-in cycle while the disturbance keeps falling. Take a formal SUD only once the disturbance seems substantially reduced [source: Manfield et al. 2021].
  2. Once the SUD has fallen to about 5 or below, switch to the standard EMDR protocol if you are EMDR-trained [source: Havens 2020, 2026].
  3. If the SUD reaches 0, go back to the target and process any remaining associative channels before the positive cognition and body scan [source: Havens 2020].
  4. If the SUD plateaus, move on to Phases 3–8 [source: Manfield et al. 2021].
  5. Repeating FT on the same memory in later sessions gave further drops, so continue while progress continues [source: Manfield et al. 2021].
  6. Low-intensity version: rate the SUD after the 3rd and 7th blocks of five, and have the client estimate their starting SUD at the end [source: Gustavson et al. 2023].
• Example language (illustrative): "If you let yourself feel it now, how disturbing would it be, 0 to 10?"
• Watch for:
  • A SUD that drops but comes back up next session. Re-target, and look for feeder memories.
  • A non-EMDR clinician reaching a plateau. Continue with your own trauma method or refer [synthesis].

4.8 Built-in troubleshooting sequence (between check-ins)

• Purpose / when: When check-ins show little change. This is the sequence from the 2021 webinar [source: Manfield et al. 2021].
• Steps:
  1. No change at check-in 2: the PEF is probably too weak. Strengthen it or change it.
  2. Check-in 3: look for a disturbing aspect of the memory that was overlooked, and target it.
  3. Check-in 4: look for an earlier related (feeder) memory adding disturbance, and target it first.
  4. Check-in 5: take a formal SUD.
  5. Other options: tapping or swaying [source: Havens 2026]; working with blocking beliefs, dissociation, other resistance and secondary gain (training topics; their content is not drawn on) [source: PESI course outline; uncertain].
• Example language (illustrative): "Is there a part of that memory we haven't touched, a sound, a moment, something someone said?" / "Does this remind you of anything earlier? Just the label, no details."
• Watch for: Clients who blame themselves for "not doing it right." Normalise this and adjust the focus.

4.9 Multiple and composite targets ("folder of targets")

• Purpose / when: To reduce trauma load efficiently in complex trauma.
• Steps:
  1. Target a time period instead of a single event, e.g. a span of years of abuse [source: Havens 2020, 2026].
  2. Or bundle several related memories under one PEF. Up to five have been reported, e.g. an EMT's five accident scenes under one holiday PEF. The client only needs to decide which memories are included, not hold them all in mind [source: Howes 2023].
  3. Keep a "folder of targets" and unpack what remains once the SUD falls [source: Havens 2020, 2026].
• Example language (illustrative): "Let's put everything from that school year in one folder. You don't need to open it. Just know the folder is there."
• Watch for: Havens does not bundle the most intense memories (SUD 10). Do those singly [source: Havens 2020, 2026].

4.10 FT inside EMDR Phase 4 (backing out)

• Purpose / when: When desensitisation becomes too intense, as an alternative to going to a calm or safe place [source: Havens 2020, 2026].
• Steps:
  1. Stop the eye-movement sets.
  2. Have the client "back out" of the target and put it to one side; Havens points to one side.
  3. Start a conversational engaging focus with triple blinks until the intensity drops.
  4. Return to the standard protocol.
• Example language (illustrative): "Let's step out of that for now and set it over there. Tell me about the match last weekend… blink."
• Watch for: Repeated need for rescue. This suggests the target was too big, so go back to Phase 2 FT on its components [synthesis].

4.11 Paired titration (precursor technique)

• Purpose / when: To approach a memory the client cannot touch at all. Manfield used it before FT existed and describes it [source: Howes 2023].
• Steps:
  1. Establish a positive image.
  2. Briefly touch a peripheral element of the trauma.
  3. Return to the positive image.
  4. Repeat until that element is tolerated.
  5. Move step by step towards more central elements. In Manfield's case: neighbourhood, then front door, then the full memory, which was then processed with standard EMDR without overwhelm.
• Example language (illustrative): "Just think of the street outside, not the house. Now back to the beach with your friend."
• Watch for: Unlike current FT, this involves deliberate brief exposure. Keep each touch very short.

4.12 Wong's "book" containment variant

• Purpose / when: For dissociation-prone clients. Wong developed it in 2018 with sober clients in a shelter [source: Wong 2021, describing Wong 2019].
• Steps:
  1. The client pictures the memory inside a closed book.
  2. On the cue, they glance quickly at the book three times, then return to the PEF.
• Example language (illustrative): "Imagine the memory is shut inside a book on the shelf. When I say 'blink,' just glance at the cover three times, quickly, then back to the music."
• Watch for: The full group script is not drawn on. Session details are [uncertain].

4.13 Grounding and relaxation-as-PEF script (low-intensity / online version)

• Purpose / when: For telehealth or low-intensity delivery, and to minimise abreaction (wooziness, sleepiness, blacking out) [source: Gustavson et al. 2023, adapting Wong 2019].
• Steps:
  1. Grounding, adapted from Shapiro's G-TEP:
     • feel the body's contact with the chair;
     • notice the sounds around you;
     • look around the room for something different;
     • notice moisture in the mouth, imagining a sour taste.
  2. Relaxation: bilateral tapping, one slow breath, then notice five areas in turn on the out-breath: neck and shoulders, back of the head, crown, forehead and eyes, face and jaw.
  3. Use that breathing body-scan as the PEF: in-breath, triple-blink, notice one area on the out-breath.
  4. After the first block of five, imagine stepping back and viewing the image from a distance.
  5. SUD after three blocks of five.
  6. Study-specific addition: identify any fitting negative cognitions (e.g. "I am not safe"), set them aside, and repeat the relaxation. The authors flag this as their own modification, not standard FT.
  7. Four more blocks, then a final SUD.
• Example language (illustrative): "Breathe in… blink-blink-blink… and as you breathe out, just notice your jaw."
• Watch for: Sleepiness or glazing. Return to the grounding steps.

4.14 Group FT

• Purpose / when: For scalable, low-intensity relief: healthcare workers during COVID, shelters, disaster and accident survivors [source: Manfield et al. 2021; Wong 2019; Gustavson et al. 2023].
• Steps, Manfield 2021 webinar format:
  1. 30 min psychoeducation.
  2. Each participant privately picks a target, either related to the event or from the past 2 years.
  3. Pre-SUD via a poll.
  4. 15-min round: the leader cues self-tapping and the blinks. Check-in 2 is used to strengthen the PEF, check-in 3 to look for an overlooked aspect, check-in 4 to look for an earlier memory.
  5. Post-SUD.
  6. Repeat the round once more.
  7. A therapist is available afterwards.
• Steps, Wong 2019: individual 30-min training first, then the group.
• Version note: Group protocols by Konuk / Yaşar et al. (Turkey) exist, but their scripts are not drawn on [uncertain].
• Example language (illustrative): "Everyone, keep your target to yourself. Just note its number in the poll."
• Watch for:
  • Participants who are unstable or poor at affect modulation. They were discouraged from the 2021 webinar.
  • Make sure you have a co-facilitator who can watch for distress and take someone aside [synthesis].

4.15 Children

• Purpose / when: FT is described as tolerable for clients of all ages, including children [source: Manfield et al. 2017 abstract]. It can be used in a first session with non-dissociative children [source: Yarberry 2021].
• Steps [source: Yarberry 2021]:
  1. Take the history at a parent-only intake.
  2. The child makes a "Worry Map" or a "Hard Stuff" list and rates each item.
  3. Target the highest-rated item.
  4. Let the child express the PEF through play: sand tray, drawing, puppets, or a therapy dog to pet and talk about.
  5. For BLS, use pulsers in pockets or wand or puppet taps so the child's hands stay free. Ask whether the child wants a parent to give the BLS.
• Example language (illustrative): "Which worry is the biggest today? You don't have to tell me what it is. Now show me with the puppets what your puppy does when you get home."
• Watch for: The outcomes reported are anecdotal. Always review with the parents at the next session.

4.16 Dissociative clients and parts

• Purpose / when: During stabilisation, after parts have been identified [source: Yarberry 2021; Wong 2019].
• Steps [source: Yarberry 2021]:
  1. Map parts and their roles.
  2. Demonstrate FT and ask whether all parts consent.
  3. Target one part's distress. Other parts may stay close for support.
  4. Build an internal resource with BLS. Teach discreet tapping for use in public.
• Example language (illustrative): "Is it OK with everyone inside if we try this with the part that holds the fear? Who would like to sit nearby?"
• Watch for:
  • Switching or losing time. Stop and ground (Section 5).
  • Work within ISSTD-consistent phase-oriented treatment [synthesis].

4.17 Telehealth delivery

• Purpose / when: FT has been delivered by video call [source: Brouwers et al. 2021; Gustavson et al. 2023; PESI course outline].
• Steps:
  1. Confirm the client is in a private, quiet room.
  2. Have a crisis plan and the client's location on file [synthesis].
  3. Have the client self-tap.
  4. Give the cues verbally, and watch the face for blinking and engagement.
• Watch for: Lag that desynchronises the cues. Keep cues spaced and clear [synthesis].

4.18 FT as pre-processing for other trauma therapies; "flashlite"

• Purpose / when:
  • To lower disturbance before CPT, exposure or other trauma-focused therapies [source: Howes 2023].
  • Trainers present it as pairable with EMDR, CPT, DBT, CBT and IFS [source: PESI course outline].
  • Havens reports a cut-down "flashlite" used by NHS crisis teams in an 18-month pilot. Its content was not found [uncertain].
• Steps: Run 4.2–4.7 on the index trauma, then begin the planned therapy with the reduced SUD documented [synthesis].
• Watch for: In exposure-based therapies, agree beforehand whether FT will be used. Avoidance of the narrative should not be reinforced when the protocol requires it [synthesis].

5. Handling problems

The sources give only the troubleshooting sequence in 4.8, plus a few practitioner notes. Everything not tagged with a source is [synthesis].

• No change after 1–2 rounds (stuck).
  • Strengthen or change the PEF. Then look for an overlooked aspect, then a feeder memory [source: Manfield et al. 2021].
  • Try adding or dropping tapping, or swaying [source: Havens 2026].
  • Still stuck: check for blocking beliefs (e.g. "if it stops hurting I'll forget them") or secondary gain. These are named as training topics [source: PESI outline], but the handling here is [synthesis]: name the belief, and target the fear of change itself as an FT target or with your usual cognitive work.
• SUD rises.
  • One small increase was reported in the 2021 webinar [source: Manfield et al. 2021].
  • Check whether the client went into the memory instead of staying with the PEF. Re-explain, use a livelier conversational PEF, and shorten contact with the target [synthesis].
  • If a new, worse memory has surfaced, label it as a separate target for later [synthesis].
• Overwhelm or abreaction mid-round.
  1. Stop the cues.
  2. Ground: name objects, feel the feet and chair, sour-taste or saliva cue [source: Gustavson et al. 2023 grounding].
  3. Use a strongly engaging conversation.
  4. Resume only when the client is in the present and agrees. Halve the dose by using a smaller slice or a feeder memory [synthesis].
  5. Inside EMDR Phase 4, use backing out (4.10) [source: Havens 2020].
• Dissociation (glazing, losing time, switching, drowsiness).
  1. Pause the work.
  2. Orient the client to time and place.
  3. Use the grounding sequence and relaxation script to reduce abreaction [source: Gustavson et al. 2023].
  4. With parts, check which part is present and whether it consented [source: Yarberry 2021, consent step].
  5. Do not resume the same target in that session if orientation is shaky [synthesis].
  6. Close with containment of the remaining material in a "folder" [synthesis, adapted from Havens' folder metaphor].
• Client keeps "going to" the memory, or can't stop thinking of it. Remind them that the instruction is to not think about it [source: Manfield et al. 2021; Howes 2023]. Make the PEF interactive: question-and-answer conversation, music, singing. Try Wong's book image (4.12).
• Client can't find a PEF (anhedonia, depression). Use a neutral but absorbing focus: breathing and body scan, a hobby conversation, a video [source: Gustavson et al. 2023; Wong 2021]. Even mild interest is enough [synthesis].
• Fear of the cue word. Avoid "flash" with veterans and childhood sexual abuse survivors [source: Havens 2020]. Use "blink" or a neutral sound.
• Avoidance or refusal of trauma work (resistance). Stress that no telling, picturing or feeling is required. FT can be done blind [source: Havens 2026; Howes 2023]. Start with a mid-level target to build trust [synthesis].
• Non-adherence (cancelling after the first session, not reporting changes). Review what changed between sessions. Clients often under-notice change, so have them estimate their starting SUD retrospectively [source: Gustavson et al. 2023]. Agree on a target list and plan the next session [synthesis].
• Rupture: the client feels "tricked" or that it was too easy or not real. Validate this. Explain that a lower SUD does not mean the event was unimportant or did not happen. Offer full EMDR or narrative work if they want the meaning processed, not just the intensity reduced [synthesis].
• Client can no longer clearly recall the memory. This was reported by some 2021 participants [source: Manfield et al. 2021]. It is usually experienced as relief. Reassure them that the factual knowledge of the event stays. Where legal testimony is possible, discuss this before treatment and document the pre-treatment account (see 4.1) [synthesis].
• Suggestion and expectancy concerns. Manfield points to effect sizes and a recorded-instruction study as arguments against pure suggestion [source: Howes 2023]. Practically, use neutral check-ins (yes/no) and keep cueing to a minimum [synthesis].
• Suicidality or crisis surfacing. Stop the work. Do a standard risk assessment and safety planning; lethal-means counselling covers storage and removal. Resume trauma work only once safety is restored [synthesis]. Gustavson et al. screened with PHQ-9 item 9 and gave prevention resources [source: Gustavson et al. 2023].
• Closing a session with residual SUD. Use a containment image ("folder"), grounding, and a brief positive-focus conversation. Tell the client that changes may continue and that new memories or dreams can surface. Give a contact plan and log anything that comes up for next session [synthesis; mirrors standard EMDR closure, not described in the FT sources].

Sources

Sources:

• Flash Technique in a Scalable Low-Intensity Group Intervention for COVID-19-Related Stress in Healthcare Providers (Manfield, Engel, Greenwald & Bullard, 2021, JEMDR 15(2))
• Processing Trauma in a Flash? (Howes interview with Philip Manfield, Psychotherapy Networker, 2023)
• Use of the Flash Technique in EMDR Therapy: Four Case Examples (Manfield, Lovett, Engel & Manfield, 2017; abstract only)
• A Model for the Flash Technique Based on Working Memory and Neuroscience Research (Wong, 2021, JEMDR 15(3))
• Flash Technique Group Protocol for Highly Dissociative Clients in a Homeless Shelter (Wong, 2019; abstract only)
• Research on Low-Intensity Flash Technique Trauma Intervention by Prelicensed Student Clinicians (Gustavson, Wong & Le, 2023, JEMDR 17(2))
• The Effects of the Flash Technique Compared to an Abbreviated EMDR Protocol (Brouwers, de Jongh & Matthijssen, 2021, Frontiers in Psychology)
• The Flash Technique for Dissociative Children (Yarberry, ISSTD News, 2021)
• EMDR and The Flash Technique: A match made in heaven? (Havens, EMDR Therapy Quarterly, 2020)
• The Flash technique: An interview with Justin Havens (EMDR Therapy Quarterly, 2026)
• Flash Technique for Trauma: Rapid Trauma Processing (Manfield & Engel, PESI course outline, 2022)
• Yaşar Alişan et al. (2022), RCT of EMDR Flash Technique after traffic accidents (abstract only)

Further reading (not drawn on) [uncertain]:

• Manfield, P., Lovett, J., Engel, L., & Manfield, D. (2017). Use of the Flash Technique in EMDR therapy: Four case examples. JEMDR, 11(4), 195–205.
• Transform How You Treat Trauma: The Comprehensive Clinical Manual for Flash Technique (book-length manual).
• Konuk (2021) Flash Group Protocol RCT, and Yaşar et al. (2021) group study. Known only through citations in Wong (2021) and Gustavson et al. (2023).
• Shapiro, F. G-TEP (group traumatic episode protocol), as adapted for grounding in Gustavson et al. (2023).