Today’s blog explores the recent important research published into the Lightning Process.

A study has been done comparing CBT and other approaches included within Specialist Medical Care (SMC) for children with CFS and the Lightning Process. It’s titled:

CBT repackaged or a novel treatment? The Lightning Process compared with UK specialist medical care for paediatric Chronic Fatigue Syndrome, and published in the peer-reviewed journal ‘Fatigue: Biomedicine, Health & Behavior’ 


The reason research has been undertaken is that Specialist Medical Care, which is a range of approaches for children with chronic fatigue has some good outcomes. But for about 1/3 of children treated they don’t do so well and are reported to have ’suboptimal outcomes’- which means little improvement after six months of treatment.

On the other hand, researchers have shown that the Lightning Process can improve outcomes in this client group, and although there is a growing body of evidence about the LP and how it works, it’s not that widely known or understood. So this project set out to address those issues.

The study was led by researchers at the University of Bristol, and they set out to identify what is similar about Lightning Process and CBT and specialist medical care and what is different, what is specific, to the Lightning Process.

Once these distinct elements could be drawn out, then it would be easier to inform clinicians about how the process worked and who it might be good for.

The Results

The results were interesting. The study identified some overlaps between CBT approaches in the Lightning Process, but also some very distinct elements.

It identified:

  1. Language
    The Lightning Process had a different focus on language and the specific use of language. It notes that, ‘A key difference arises in language use, with the LP placing special emphasis on language, where SMC approaches do not.’ and describes the use of active language:

‘LP goes further and teaches the linguistic concept of ‘dȗ’ and passive versus active language [12]. Clients are taught to change passive statements using the term, so for example ‘I have anxiety’ becomes, ‘I’m dȗing anxiety’; ‘I’m tired because … ’ becomes ‘I’m dȗing tired’ aiming to transform problem feelings into active verbs. It is designed to sound odd to disrupt habitual thinking, reminding clients of their agency in creating solutions. CBT would term this ‘cognitive restructuring’, though would tend to foster patient agency by examining unhelpful thought processes and conducting behavioural experiments rather than changing language per se.’

  1. Neurophysiological approach
    It noted that CBT focused on physical and behavioural issues, so physical issues such as improving sleep and exercise, behavioural issues such as improving routines around sleep and exercise and pacing. It also looked at things like over focusing on symptoms.
    However, the Lightning Process had a different perspective. It had a consistent neurophysiological rationale for making change to the illness.
    This point is particularly interesting. The Lightning Process looks at the mind body connection. How people can use their mind to affect their brain to affect their body, and so make changes to their physiology. For many people, as soon as they hear the word mind they think, ‘The Lightning Process is suggesting the illness caused by things in the mind’, but this is a misunderstanding which is clarified in this paper.
    The Lightning Process looks at changing physiology but achieves that result by helping people to learn how to use their brains to retrain their neurology to change their physiology.
  2. Techniques to changes to physiological state
    It also noted the Lightning Process had some very specific techniques designed to change affective state and physiology that were not present in CBT approaches.
  3. Delivery
    That the way the LP was delivered was different. While CBT was often delivered once a week, the Lightning Process seminars are delivered over three consecutive days.
  4. Movement and body posture
    It also noted that kinetic elements were part of the Lightning Process. That is, the use of movement, postures and gestures and the importance of congruency in the use of these movements, to assist the brain training process.
  5. Compassionate self-coaching
    The authors also noted the presence of compassionate self-coaching in the approach not seen in the CBT approaches.

This valuable research project identifies the distinct elements of the Lightning Process and that although it has some overlap with some elements of CBT the Lightning Process is not just another form of CBT.

It suggests that this might be very interesting material for the design of future interventions and research to improve clinical outcomes for children with CFS/ME, and it’s really valuable for helping clinicians to be more informed about treatment options available for families.