In a UCSF Weill Institute webinar, Dr. Phil Manfield, a leading EMDR trauma therapist, presents the Flash Technique—a brief, group‑deliverable EMDR‑derived intervention that enables clients to process disturbing memories without consciously feeling the disturbance. He outlines the technique’s core steps: establishing a Positive Engaging Focus (PEF) that distracts from the memory, bilateral thigh tapping, and a rapid series of eye‑blinks (“flash”), followed by repeated check‑ins that typically shift the memory’s vividness and emotional intensity farther away, eventually eliminating disturbance after 6‑7 cycles. Manfield explains the hypothesized mechanism as a reduction of trauma‑related time distortion, fostering an adult observer perspective. He reviews the research base: nine published papers (including two peer‑reviewed RCTs), four ongoing RCTs, and a large‑scale group study with 175 Pennsylvania healthcare workers that showed a 55‑69% reduction in self‑reported disturbance after 10‑15‑minute interventions, with stable or improved effects at 1‑week and 1.5‑year follow‑ups. He highlights the technique’s scalability—delivered via webinars, group sessions, and a 3,300‑member clinician listserv—and mentions forthcoming fMRI work and new studies targeting COVID‑19 victims. The webinar also promises a live 10‑15‑minute Flash Technique demonstration for participants. Throughout, Manfield emphasizes the technique’s safety, rapid impact, and potential to make broader psychotherapy more accessible.
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Mm-hmm.
Now we're on to Dr. Phil Manfield, wonderful colleague of many years in the San Francisco Bay Area, and I don't exaggerate. At all when I say he's just one of the world's top trauma therapists in the EMDR world and outside of that. He's written countless books, maybe 9. He provides EMDR videos for free on the internet. He's done an awful lot for the EMDR trauma community to provide free trainings and consultations. He's teaches advanced and beginning and flash, and he's one of the most prolific trainers and teachers that I've ever met. I'm glad to introduce you now, Phil, and I'm certain we're going to hear some interesting things because I always learn more things when I hear you speak. Take it away, Phil.
Thank you, David, for creating this venue. It seems to me that this is very unique in that we're hearing from an academic researcher who is establishing that processing is more efficient if a person's not consciously aware of feeling disturbed. And our clinical work, which is based on the principle that people process more effectively if they are not aware of being disturbed— so this is a very special occasion to have both of these presentations in the same webinar. So I've been very fortunate that since introducing the Flash Technique, I've had some wonderful clinicians who have recognized the importance of the Flash Technique and gotten in on the ground floor and helped me to present the Flash Technique to the world. In particular, psychologists Louis Engel, Nina Zadurian, David Bullard, Ricky Greenwald, and behavioral pediatrician Joan Lovett. Joan, Louis, and my brother David were co-authors in the original paper about the Flash Technique that was published in 2017. Since then, Louis has been a part of all my Flash activities, trainings, publications, research. He's been right there from the beginning in helping people to recognize the importance of the Flash Technique. And I think the wonderful thing about this is that, um, Flash Technique can be done in groups. And so when we present to a group, we always do at least one 15-minute intervention where people get to experience the Flash Technique themselves. And that, I think, has gone a long way towards having people recognize that this is something that works. We're also going to give you the experience of having, uh, participating in a 10 to 15 minute Flash Technique exercise that we're going to do at the end of the recording of this webinar. So if you're watching this live You can stay on and we'll do this intervention immediately afterwards. So the Flash Technique is unique, pretty unique, in that people process either very disturbing or moderately disturbing memories, and they do it without feeling the disturbance consciously. The mechanism for this is that we have people think of what we call a positive engaging focus, something that is engaging that the client can focus on. And while they're focusing on it, they're not thinking of their disturbing memory. While they're doing this, we have them tapping their thighs, form of bilateral stimulation, which is common in EMDR. And we say the word "flash," and when we do, they blink their eyes 3, 4, 5 times like a flutter. And after we've done that 5, 6 times, we check in with them to see if they notice any change in their disturbing memory. And we encourage them to do that without thinking of any of the details and without focusing intensely on the memory. Then we go back and start again with the tapping, the PEF, and the blinking. And we notice that with each check-in where we ask if anything has changed, people do report change. And gradually, well, the first thing they seem to report is that the memory seems further away. And as I'll say in a few minutes, that's consistent with our understanding about what happens when people experience a Flash Technique. Then they start reporting that the image is vague or the memory is vague. Sometimes they report it's hard to bring it up. But gradually the trend is that they feel less and less disturbance when they think of the memory. And typically at about 6 or 7 of these check-ins, they're at a point where they're not feeling any disturbance at all when they think of the memory. The key to Flash Technique, what really makes it work, is the positive engaging focus. And we think of it as our version of what Paul refers to as a VBE. In other words, it's a focus that prevents clients from thinking of their disturbance. And since we started doing it, we found better and better ways to do it. One of the— we have a listserv with 3,300 clinicians, and one of the clinicians, Gina Ornelas, wrote in one day, oh, I have my clients talking to me about their positive engaging focus, and that seems to help them to stay focused, and it seems to make it more effective as a distraction. So we tried it, and absolutely, it, it's, uh, it's another step forward in being more effective with the Flash Technique. So we've been doing that ever since. Of course, we don't do that when we do a group intervention, but FLASH works whether or not a person is relating to someone else about their positive engaging focus. What we think is going on with the FLASH technique, and we don't have any fMRI yet to to substantiate that, but we do have one fMRI that has been approved and is in the process of being set up. What we think is going on is that, um, there's a healing of the time distortion that seems to be inherent in trauma memories. And so when a person thinks of a trauma memory, people who have PTSD have the experience of having that trauma, uh, as if it's happening all over again. They feel like they're there. And, um, so we think the healing of those, uh, traumas is for a person to develop an adult perspective and to recognize that they're here now and they're no longer experiencing what they experienced before. So, uh, that was then and this is now. Now we work with a wider range of memories than what the DSM would characterize as a trauma memory that could be related to PTSD. Um, memories that we work with don't have to involve violence. They can involve extreme shame or humiliation. They can involve terrible sadness. Um, the key element that we look for is that when the client thinks of the memory, they feel like they're back there and it's happening in the present. So that's what makes these memories so disturbing. That people relive them and they feel the disturbance as they recall them. So that's what I mean by when a client says, I feel like it's— it seems further away. That's a sign to us that the healing is happening. And that sense that goes with the disturbing memory initially of persons right there As they report that it seems further away, they also report that they have more of an adult observer function available to them, and gradually they see the memory as something that happened in the past and is not ongoing now. So we've been very fortunate that, um, As people recognize that flash is effective, quite a few people have taken it on as a research subject and begun studies. Initially, that was difficult because most institutional review boards, before they would approve a study, they wanted to know that flash was safe. And we didn't have any research that demonstrated it, it was safe because we couldn't get an IRB to approve it. And really what started the initial research was various researchers who either experienced the Flash Technique themselves or they experimented with it clinically and they found that there were very rapid and startling, um, processing effects. So I think it was basically on the personal assurances that some of these researchers gave to their IRBs that enabled the IRBs to accept the safety of flash technique and approve the initial research. Presently, we have 9 papers that have been published about Flash Technique. One of those is in press currently. We've had 2 published RCTs and we have 4 RCTs currently in process. We have done a number of studies ourselves. Since then, uh, we were approached by a union in Pennsylvania with 40,000 healthcare worker members who were suffering because a lot of their clients had COVID-19, and it was very upsetting, especially early on, trying to treat all the people who needed treatment. So the union asked us if we could develop a cost-effective, scalable technique that could give relief to the union members. And so we started a study in which we provided FLASH as a group intervention to 175 participants, volunteers, and We divided them into work— people who were providing mental health and people who were providing other healthcare. We got excellent results on average. We gave people a webinar that was an hour long and we provided two flash interventions, each 10 to 15 minutes. In each webinar. The subjects took one webinar. If they took more than one webinar, we only counted the first one. And the results of this group intervention in which they were basically following our directions and they weren't— they didn't have the ability to ask questions or relate to us in any way. So we could have been a video recording of us doing this. And in the initial intervention, the average reduction in disturbance measured from 0 to 10, with 0 not disturbing at all and 10 the worst they could imagine. Initial reduction was 55% from this it was probably a 12-minute intervention. And then in the second intervention, some of them chose to use the same target they'd used in the first one, and those people got an average of 69% reduction in their disturbance. So that paper was published in June. As you can see from this graph, typically People started with a disturbance level of 7 or 8, most common SUDS level, disturbance level. When they ended the 10 or 12-minute intervention was about 2. And then we did a 1-week follow-up and the reduction was stable and actually improved somewhat in the follow-up. In the earlier study that didn't get published, we also did a 1.5-year follow-up of the people who started out most disturbed, and those results also held, and there was improvement during the year and a half.
This research is coming out of the researchers' pockets, to finance it and what we're showing is that 15 minutes of group flash reduces disturbance significantly. Our effect sizes were over 3. That's really, really strong impacts. The next thing to do is to do research where we have repeated webinars. Right now we're starting a study with COVID victims. We're not attempting to cure them, But if they can get a reduction in their suffering from 15 minutes, that's great. And then they're going to be more easily treated with other forms of psychotherapy or with someone who's doing flash therapy with them individually. So I agree, it's, it's not a one-size-fits-all, but flash seems to make psychotherapy easier for clients because that extreme activation goes down and they're just less resistant to looking at their trauma experiences.
When I train psychotherapists in the EMDR technique and working with complex PTSD and and early trauma, there's a place for finding a way to bring those traumas into focus and then reducing their impact. And it does have an impact on their present-day experience of life.
But obviously, in a one-to-one situation, therapist is going to be more effective.
But we have an overwhelming amount of trauma in this country right now. And I think we have to look for ways, not necessarily to cure people, but to make the suffering less.
Thank you all for the work that you've done and continue to do and will do in the future, because this really is about trying to relieve human suffering.
