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Flashforward Procedure”: Confronting the Catastrophe

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Flashforward Procedure”: Confronting the Catastrophe With the Compliments of Springer Publishing Company, LLC JOURNAL OF EMDR PRACTICE AND RESEARCH www.springerpub.com/emdr The “Flashforward Procedure”: Confronting the Catastrophe Robin David Julian Logie Chorley, Lancashire, United Kingdom Ad De Jongh University of Amsterdam and VU University, Amsterdam, Netherlands This article introduces the “Flashforward procedure,” which is a specific application of eye movement desensitization and reprocessing (EMDR). It is used for the treatment of irrational fears, for example, when a persisting fear continues after the core memories of past events have been fully processed. A theoretical background is presented, and the procedure is explained, together with 2 illustrative case studies. We describe psychological conditions and mental health problems for which the use of EMDR aimed at client’s flashforward might be appropriate, as well as indicating which stage in the therapeutic process is most applicable for the use of this procedure. Furthermore, the Flashforward procedure is compared with other EMDR applications and similar procedures in other therapies. Some implications are discussed. Keywords: Flashforward; EMDR; Future Template; anticipatory fears; catastrophic fears ye movement desensitization and reprocessing divisions of the targets are defined in the standard (EMDR) was developed in 1987 by Francine protocol as follows. First, the past experiences that E Shapiro for the treatment of traumatic memo- have set the groundwork for the pathology are fully ries (Shapiro, 2001). EMDR has since grown from a processed. desensitization technique into an integrated psycho- Next, the focus of the therapy shifts to the second therapeutic treatment approach (Solomon & Shapiro, prong, which is aimed at the processing of specific 2008). This therapy is underpinned by the Adaptive triggers that currently elicit disturbance for the client. Information Processing (AIP) model, which theorizes According to Shapiro (2006), some triggers could still that psychological disorders arise from unprocessed remain active even though the original traumas were information that is dysfunctionally stored in the brain apparently processed. Shapiro hypothesizes that these (Shapiro, 2001). triggers may be fed by some residual information from earlier events that have not been completely The Three-Pronged Protocol processed, or may be caused by second order condi- tioning. These triggers could be an external situation The standard protocol for EMDR therapy consists of a or an internal sensation (e.g., manifestation of antici- “three-pronged” (past, present, and future) approach patory fear such as dizziness). in which, initially, past events, then present issues, Finally, in the third-prong of EMDR, called the and finally anticipated future situations are targeted Future Template, treatment helps the client to visual- in therapy. The processing of past events would nor- ize successfully managing an anticipated future event. mally always be the starting point of the processing According to the standard procedure, if there are any phase of EMDR therapy, and the processing of such blocks, anxieties, or fears that arise when a client thinks events will usually resolve current psychological about a future scene, the client is asked to focus on problems. According to Shapiro (2001), the standard these blocks and several sets of eye moments are in- three-pronged EMDR protocol guides the overall troduced. If the blocks do not resolve, Shapiro (2006) treatment of the client. Each reprocessing session recommends providing the client with adequate in- must be directed at a particular target. The generic formation, resources, and skills that enables them to Journal of EMDR Practice and Research, Volume 8, Number 1, 2014 25 © 2014 EMDR International Association http://dx.doi.org/10.1891/1933-3196.8.1.25 Copyright © Springer Publishing Company, LLC comfortably visualize the future coping scene or to use flashforwards, that is, negative intrusive visual im- the Affect Scan or the Floatback technique to identify ages about events they feared might happen to them old targets related to blocks, anxieties, or fears. The in the future (e.g., having a blackout during a pre- standard protocol is then applied to address these tar- sentation, the funeral of a loved one, being hit by a gets. If there are no apparent blocks and “the client is car). Events that had already happened to them in able to visualize the future scene with confidence and the past were excluded. Then the participants were clarity” (Shapiro, 2006, p. 52), the third prong (Future randomly assigned to either “recall with eye move- Template) is installed. This is done by asking the client ments” or “recall only” conditions. Next, four sets to focus on the image, positive belief, and sensations of eye movements were employed of 24 seconds associated with this future scene and introduce sets of each with 10-second breaks in between. Before and eye movements “to assist him/her in assimilating the after the experiment, participants were asked to re- information and incorporating it into a positive tem- trieve the image and to rate its vividness and emo- plate for future action” (Shapiro, 2006, p. 51). tional intensity. The results of the first study (n 5 28; Engelhard et al., 2010) showed that the vividness and The Flashforward Procedure emotional intensity of the future-oriented images significantly decreased after recall with eye move- This article describes the Flashforward procedure, an ments, relative to recall only. The second study application of EMDR that can be applied as a tech- (n 5 37; Engelhard et al., 2011) used a sample of nique to address clients’ irrational fears, which persist female students who indicated on a screening scale after the core memories of past events appear to have that they suffer from flashforwards. The results rep- been fully processed. To this end, the Flashforward licated those from the first study in that vividness of procedure can be considered an intervention that can the flashforwards had decreased after recall with eye be used within the second prong (“present”) of Sha- movements, compared to recall only. There was a piro’s three-pronged approach. Even though the cli- similar trend for emotional intensity, but recall with ent’s focus is on the future, the fears are experienced eye movements did not significantly reduce vivid- in the present, triggered by anticipatory thoughts, and ness from pretest to posttest, a finding the authors so they are considered current fears suitable for pro- attributed to a problem of statistical power. cessing in the second prong. Holmes, Crane, Fennell, and Williams (2007) This article describes what a flashforward is, to- originally used the term Flash-forwards to refer to sui- gether with the mental health problems for which the cide-related images. Engelhard et al. (2011) described use of EMDR aimed at the client’s flashforward might the term flashforwards by stating that be appropriate. The article further describes the stage in the therapeutic process that is most applicable for . fear of future danger is common after a the use of this procedure and illustrates the procedure threatening event, and may take the form of with two case studies. Finally, a theoretical back- future-oriented mental images. These may ap- ground of the Flashforward procedure is presented pear like “flashforwards,” echoing “flashbacks” and explained. in posttraumatic stress disorder (PTSD) and pos- sess sensory qualities, being vivid, compelling, Research Background for the and detailed. (p. 599) Flashforward Procedure Thus, rather than referring to an anticipated and pre- It has been shown that employing eye movements dictable event, EMDR focused on someone’s flashfor- and related working memory tasks typically results ward relates to the processing of an image of a feared in an amelioration of the emotionality of memories, catastrophe, in other words, the mental representa- not only for resolving unprocessed memories un- tion of someone’s “worst thing that could happen” derlying posttraumatic stress disorder (PTSD) but or “anticipated doom scenario.” In fact, when a cli- also for those in other mental conditions (De Jongh, ent suffers from a fear, by definition, there must be an Ernst, Marques, & Hornsveld, 2013). Two recent anticipated catastrophic future event. In this respect, analogue studies have shown that intrusive images EMDR focused on someone’s flashforward should be about potential future catastrophes can also be ame- conceptualized as an intervention that can be used liorated by taxing working memory using eye move- within the second prong of the protocol because it ments (Engelhard et al., 2011; Engelhard, van Uijen, concerns what the client still currently actively fears. & van den Hout, 2010; Van den Hout et al., 2011). It should be noted that even if the fear is of some fu- In both studies, participants were asked to select two ture event, which may not occur for more than a year 26 Journal of EMDR Practice and Research, Volume 8, Number 1, 2014 Logie and De Jongh Copyright © Springer Publishing Company, LLC (perhaps a flight or a visit to the dentist), the client video procedure that is part of the Phobia Protocol may still be currently preoccupied by their anticipated (Shapiro, 2001) and the use of exposure in vivo or so fear of this event. called behavioral experiments (see De Jongh, 2009). The use of these cognitive behavioral procedures can be Previous Applications of the Flashforward helpful in case it is deemed necessary for the client to Procedure learn to be exposed to the feared situation until she has achieved a degree of self-mastery and feels able to The only published description of the use of Flash- handle a certain level of anticipatory anxiety and fear forward procedures in a clinical context is by with confidence again. Romain (2013). She describes the successful appli- Here are some procedures that might be used cation of EMDR on clients’ flashforwards using the within the context of treatment with EMDR: EMDR standard protocol in two cases.
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