A Model for the Flash Technique Based on Working Memory and Neuroscience Research

2021 ◽  
Vol 15 (3) ◽  
pp. 174-184
Author(s):  
Sik-Lam Wong

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.

2021 ◽  
pp. EMDR-D-20-00048
Author(s):  
Sik-Lam Wong

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.


Author(s):  
Jun Inoue ◽  
Kayako Matsuo ◽  
Toshiki Iwabuchi ◽  
Yasuo Takehara ◽  
Hidenori Yamasue

Abstract To characterize the brain responses to traumatic memories in posttraumatic stress disorder (PTSD), we conducted task-employed functional magnetic resonance imaging and, in the process, devised a simple but innovative approach—correlation computation between task conditions. A script-driven imagery task was used to compare the responses to a script of the patients’ own traumatic memories and that of tooth brushing as a daily activity and to evaluate how eye movement desensitization and reprocessing (EMDR), an established therapy for PTSD, resolved the alterations in patients. Nine patients with PTSD (7 females, aged 27–50 years) and nine age- and gender-matched healthy controls participated in this study. Six patients underwent the second scan under the same paradigm after EMDR. We discovered intense negative correlations between daily and traumatic memory conditions in broad areas, including the hippocampus; patients who had an intense suppression of activation during daily recognition showed an intense activation while remembering a traumatic memory, whereas patients who had a hyperarousal in daily recognition showed an intense suppression while remembering a traumatic memory as a form of “shut-down.” Moreover, the magnitude of the discrepancy was reduced in patients who remitted after EMDR, which might predict an improved prognosis of PTSD.


2020 ◽  
Author(s):  
Chantelle S. Lloyd ◽  
Andrew A. Nicholson ◽  
Maria Densmore ◽  
Jean Théberge ◽  
Richard W. J. Neufeld ◽  
...  

2015 ◽  
Vol 225 (1-2) ◽  
pp. 31-39 ◽  
Author(s):  
Nellie E. Wood ◽  
Maria L. Rosasco ◽  
Alina M. Suris ◽  
Justin D. Spring ◽  
Marie-France Marin ◽  
...  

CNS Spectrums ◽  
2016 ◽  
Vol 22 (4) ◽  
pp. 363-372 ◽  
Author(s):  
Michael D. Nelson ◽  
Alecia M. Tumpap

ObjectiveMany studies have reported hippocampal volume reductions associated with posttraumatic stress disorder (PTSD), while others have not. Here we provide an updated meta-analysis of such reductions associated with PTSD and evaluate the association between symptom severity and hippocampal volume.MethodsA total of 37 studies met the criteria for inclusion in the meta-analysis. Mean effect sizes (Hedges’ g) and 95% confidence intervals (CI95%) were computed for each study and then averaged to obtain an overall mean effect size across studies. Meta-regression was employed to examine the relationship between PTSD symptom severity and hippocampal volume.ResultsResults showed that PTSD is associated with significant bilateral reduction of the hippocampus (left hippocampus effect size=–0.400, p<0.001, 5.24% reduction; right hippocampus effect size=–0.462, p<0.001, 5.23% reduction). Symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS), was significantly associated with decreased left, but not right, hippocampal volume.ConclusionsPTSD was associated with significant bilateral volume reduction of the hippocampus. Increased symptom severity was significantly associated with reduced left hippocampal volume. This finding is consistent with the hypothesis that PTSD is more neurotoxic to the left hippocampus than to the right. However, whether the association between PTSD and lower hippocampal volume reflects a consequence of or a predisposition to PTSD remains unclear. More prospective studies are needed in this area.


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