(Session One) Preparation and Using the Flash Technique
We would like to share some information regarding the process of EMDR to help you determine if it’s something that could benefit you. This is a made up example based loosely on people we’ve seen here at Revive. This example is based around Performance Anxiety.
Background to the case of “Tom” and his Performance Anxiety
Tom is a 31 year old office worker who has wanted to change his job for a number of years, but every time he thinks about going for a job interview, in his words he starts to “freak out” – he is sure that he will present badly and experience the most embarrassing interview of his life (he has performance anxiety).
He experiences physical symptoms of anxiety including sweating profusely, rapid heart rate and feeling shaky.
He recalled a specific job interview with an employer he didn’t know a few years ago, where he went blank and experienced a panic attack during the interview and he decided to leave. He continues to feel anxious and embarrassed when he thinks of the memory.
For this reason he avoids compiling his resume or looking at job ads online. He tells himself, “what is the point”. He believes that he will perform similarly if he tries again. He feels “stuck” to stay in his current job, where there is no opportunity to develop his skills.
Setting up for EMDR:
After teaching Tom some self soothing strategies including deep breathing and relaxation and visualisation strategies, preparation for EMDR involves defining what his negative belief about himself is, when he is thinking about a job interview.
He chooses, “I cannot succeed” as his negative belief. When asked what intensity of emotional distress he experiences when he thinks of going for a job interview, he rates it as being a 8 out of 10, where 0 is no emotional distress and 10 is the most extreme emotional distress that you could imagine. He is also asked, how in the future he would like to change his belief about himself and his performance anxiety to a positive interpretation of his ability to undergo job interviews. He chooses, “I can handle it”. When asked to rate how true does the positive belief, “I can handle it”, feel to him when he thinks of a job interview, he rates it as being 10%, where 0% is not true at all, and 100% is absolutely true.
Higher scores involve using the “Flash Technique” before the standard EMDR:
As his commencing score is 8 out of 10, the first EMDR technique provided, is the “Flash Technique”, which involves him thinking of a “special place” which is pleasurable and enjoyable to him, while following the movement of the therapist’s pen from left to right over a period of about 30-60 seconds.
He describes a beach scene for his special place, and instruction is given to bring the special place to mind, noticing what his senses can notice, and with focus on what brings him a sense of pleasure.
When he confirms that he has successfully imagined the special place, and experienced pleasure and relaxation, the second step is instructed, asking him to firstly imagine the special place, and then asking him to flick to the “target memory” – in his case the memory of the job interview that he left in panic and shame.
The basic process is to continue with alternating between the special place, and the target memory until the target memory has reduced to at least a 6 out of 10. It is usually relatively quick in doing so, taking between 15 and 30 minutes to reduce to a 6 out of 10, and sometimes people report an even lower rating of 4 out of 10, or 2 out of 10 in a relatively short time. For some people, it takes longer than this, and they may take more than 30 minutes to reduce to a 7 or 6 out of 10.
Here is an example of how Tom may have responded:
First eye movement (EM 1) with special place, flick to the memory and back to the special place: The therapist’s asks, “what did you notice?” Tom responds, “I started to feel shaky and sweaty”.
Often to begin with, people stay with the target memory (the job interview in this case) for a longer than they need to, for the Flash Technique. The therapist instructs him that he can “flick” or “flash” the memory much quicker, that it only needs to be for a fraction of a second. Over a few more eye movements, Tom gets the hang of “flicking” the memory much more quickly, and immersing himself in the pleasure of the special place he is visiting.
By EM4, he is stating that he is no longer experiencing any physical feelings of anxiety when he “flicks” and he is feeling calm.
Over subsequent EMs the therapist suggests to do double “flicks”, which involves going to the special place, to the memory, to the special place, to the memory and back to the special place. This is repeated a number of times, and Tom is able to successfully do so.
At the conclusion of 15- 20 minutes of doing this technique, when the therapist checks in with Tom for a rating, he reports that he now experiences the memory as being a 6 out of 10. Tom described feeling encouraged by how well the procedure has worked already, as he is now able to hold the memory in mind much more comfortably than he did prior to doing it.
This is a good place to conclude the session, with view of starting the “standard EMDR” for next session. Tom is informed that people often feel somewhat tired after the session as his brain has been working hard, and that usually his rating of 6 out of 10 is maintained until the next session.
– Stay tuned for the next instalment I hope you’ve enjoyed learning about EMDR, with this example, “first session” on performance anxiety – The next article, will demonstrate and an example “second session”