Session three: The focused session

Even though Jade seemed to feel somewhat better towards the end of the session (change), she was still doubtful, as she expressed in her comment “I felt like leaving something behind” at the end of the session.

The internal conflict/dilemma (difficulty, affect) was reflected in the contrasting messages from the expressive media: drawing and music. The drawing seemed to reflect and bring out Jade’s vivid feelings of helplessness and despair (affect): the dead body that could not move “struggling to escape from the darkness ... the endless, endless grey sky [being] exhausted, suffering”. The music seemed to match her conscious will to mobilize some energy which was not yet owned by Jade: “wake up, follow me”.

In desperation, Sera forced four music and imagery processes on Jade (therapeutic intervention), perhaps because she was afraid of herself also being stuck in a similar dark, grey place like Jade (affect, difficulty).

Sera was emotionally too merged with Jade, it hampered the way she intervened in Jade’s processing of her supportive resource (supportive imagery). The supervision was focused on Sera learning to separate herself from Jade and understand her

countertransference (relationship).

5.3 Session three: The focused session

5.3.1 Session process

The session was recorded on video. Sera faced the camera and Jade was in profile.

Sera reported that Jade arrived at the therapy office before her, 40 minutes prior to the scheduled time. Sera noted that she felt taken aback but that she was able to keep calm and started the session on time as scheduled.

a. Prelude/Transition

As soon as the session started, Jade “excitedly reported positive changes” in her life and her attitude. Sera reported that Jade “looked bright and high-spirited” and she told Sera that she had started Air and Correspondence College (similar to The Open University), despite severe opposition from her husband. Jade also “showed off” by saying that she had “passed a job interview after three screening processes” but she had

to give up because her husband would not allow it. As she focused on herself and socialized with her peers at her school, she felt good and “alive” and she felt she had

“returned to my old self” who had been laid back and confident. Jade reported that she gained strength especially when she listened to the music and thought of the image from the last session, “a tiny bird becoming a big eagle flying high”. However, towards the end of the prelude, Jade started to express some doubt and anxiety over these new changes in her life. Jade “felt very guilty” when her son Hun got injured playing outside and came home with “blood all over him”. Her husband blamed Jade for Hun's injury and demanded Jade withdraw from school. Jade felt upset about her husband being a 'stumbling block'. She expressed her conflict: “I felt so terrible. Even though I knew that it was not my fault I felt very guilty… I got so tired of everything and kept thinking to myself… shall I give up? No, I shouldn't.”

Immediately after that, Sera moved to the transition asking Jade to look at her drawing from the previous session and if she could recall the feeling of being “alive” when she studied at her new school. Sera noted that Jade “smiled”, nodded and answered timidly

“well”. Without exploring the chosen imagery further with Jade, Sera immediately started the induction. Observing the video now as a researcher, I feel Jade appeared rather reserved and her smile was restricted. I wonder if, by answering “well”, Jade was expressing her doubts rather than “yes”. I find the discrepancy between her body

language (nodding) and her answer interesting as it may display the mixed feelings Jade had about the changes in her life.

b. Induction

Sera asked Jade to close her eyes, repeat several breathing exercises and imagine sending “the feeling of being alive and the support and comfort from people who were with you” to all of her body. At the end of the induction, Sera chose the music for Jade and turned the music on.

The process of the induction was very detailed and was rather long, making it feel close to a GIM induction. It was possible that a detailed induction would not hold Jade at the feeling of the chosen imagery but may lead her to a deeper psychological state (altered state) and stir up complex psychological/emotional material.

c. Music

Sera reported that she chose a short piano piece by Kabalevsky (1937-1938), Op.27, No.18 because she felt that “the cheerful rhythm of the music may reflect 'feeling alive'” for Jade. This music was also played again in a section of the postlude.

This piece was a part of a collection of piano pieces written for children by Kabalevsky, a 20^th century Russian composer. The piece is simple and very short, lasting about one and a half minutes. It is a modern period piece of classical music with an ethnic nuance in its unusual use of a minor scale (a natural minor). The melody sounds jumpy in dotted rhythms and is accompanied by staccato chords with a regular beat. It is simply structured with several repetitions of the main melodic theme. I find that the performance is static and monotonous with minimal dynamic contours and flow and the interpretation of the staccato sounds mechanical. Thus, the piece sounds slower than its tempo mark “allegretto” (moderately fast) suggests. The simplicity in all elements of this piece and its few changes meet the criteria for SMI music (Summer 2005, 2007, 2008a), except for the constant key changes. Despite this, I find that the piece is aesthetically limiting, with little expressive quality, it thus may have limitations in bringing out a richer emotional quality.

d. Music and imagery

Jade closed her eyes while the music was repeated (about three minutes altogether) until Sera instructed her to open her eyes. She seemed hesitant to draw at first and then she quickly drew (in about one and a half minutes) a faint image of a fountain.

Figure 5.4 Drawing from session three. Title: The soaring (sprouting) water from a fountain.

e. Postlude

Jade began explaining the positive message she got from “the soaring water from the fountain” in her drawing, “don't sit there, come up ... don't give up”. However, when Sera asked how she felt, Jade expressed her doubts and conflicted feelings, laughing nervously as she spoke: “There were two minds coming up … A--h! (sigh). What if I cannot do it because I am afraid of it? On the other hand, I feel ‘yes, I can do it’.” Sera then asked Jade what message she heard in the music. Jade responded that she felt encouraged by the music, “you can do it”. Hearing this, Sera turned up the volume of the music and asked Jade to focus on the “voice of the music”. After listening to the music, Jade seemed more anxious, complaining of “feeling complicated, like in a swirl”. Jade laughed as she talked without looking at Sera.

As soon as Sera heard this she immediately changed the CD, but she stumbled a couple of times before she found the piece she was looking for. Jade patiently waited with closed eyes. Before turning on the second piece, Sera instructed Jade to look at the image of the fountain and focus on its positive message. Sera conducted another induction for the second piece of music with the image of the soaring fountain, letting Jade feel “the power of the shooting water … let yourself go with it”.

Sera turned on the music, “Hamabe no Uta” (Narita, 1996), which was used in the previous session (Session two) and which Jade claimed had been “very helpful” to her.

The piece is gentle and simple with a beautifully expressive quality. The warm and

clear lyric melody is played by the cello with a soft piano accompaniment. (See chapter 4 for a more detailed description of this music.)

The music was played only once while Jade kept her eyes closed. After the music was over, Jade complained she could not focus and seemed confused: “The image keeps being scattered … Ah! The water keeps filling up, flooding the fountain. No! The fountain is disappearing, it shouldn't!” On Sera's suggestion, Jade quickly added to her drawing. Sera described in her report: “Jade added more water shooting up, water filling up the area with horizontal waves and mountains in the background”.

This last therapeutic intervention by Sera with different music and added drawing (expressive media) seemed only to highlight the conflict and anxiety Jade experienced.

Jade expressed how shaken and nervous she was about her changes and how torn she was between “moving forward” and “giving up”. Sera’s attempt to make Jade pay attention to the positive messages from the music (moving forward) and drawing (shooting upward), seemed to accentuate the conflict further, leaving Jade feel “very complex” and “fluttering”. Jade said: “I need to move forward but I feel I am blocked

… I feel tempted to give up and to be comfortable being settled with what I have but the thought makes me feel suffocated” (affect, difficulty).

Hearing this, Sera finally seemed to acknowledge Jade's ambivalent and conflicted feelings and she listened to Jade attentively (change, therapeutic intervention). From this moment on, I sense a little shift of energy (change) in both Jade and Sera being somewhat less nervous and calmer. As soon as Sera accepted and validated Jade's feelings, she seemed to become less anxious and somewhat calm (intervention, relationship, affect, change). Jade spoke with clearer diction and a calmer voice, turning her body towards Sera and looking at her as she spoke. Sera responded to Jade with a relaxed composure. They responded to each other with a natural reflective flow of give and take, at a slower pace with pauses in between (relationship, change).

At the end of the session, Sera provided Jade with the music files used in the session, commenting that the music might help Jade to reflect (supportive imagery). Sera noted

that, in contrast to the last session, Jade did not want to take her drawing with her but accepted the music files. Sera reported that she provided information on a counselling programme for husbands and couples at a Catholic church as they ended the session.

It is interesting that Jade did not take the drawing (expressive media), which

symbolized her conflicts explicitly (affect): The fountain’s water shooting up and her desire to move forward were being submerged by a flood, which represented her giving up her desire. She felt like she was being “suffocated”.

5.3.2 Written Report

Sera sent her report for session three after she had conducted the next session (session four). Sera's written report was disorganized, with many sections being mixed and repeated. The report was so badly organised, it took me a while to figure out and understand the content. The disorganized layout of the report perhaps reflected how Sera was infused with Jade's feeling of confusion. However, the content was

impressive. Sera showed great insight into the session process and exhibited empathic understanding for her client, Jade.

Sera reflected that she had been rather “pushy” for Jade to accept her “positive

imagery”. Sera thought that it would have been better to work with Jade to choose her own positive imagery. Sera questioned if she should have used a calmer, more

comfortable piece of music instead of the first piece, Sonatina (Kabalevsky, 1937-1938). She wrote, “Jade loved 'feeling alive' yet that specific feeling also stirred anxiety in her.” Sera realized that she “had tried too hard” to pull Jade up, which may have sparked Jade's anxiety as a counter-reaction. Sera regretted that she had not “explored the 'positive imagery' enough” before she played the second piece, “Hamabe no Uta”

(Narita, 1996). She felt she had been overly nervous about Jade's reaction at times.

5.3.3 Supervision

This third session was a difficult and important session for both Jade and Sera. Jade was confused over the changes in her life after the short gains made after the second session. I had a very high regard for Sera's talent as a therapist but I remember feeling puzzled and frustrated at Sera for her not seeking supervision when she needed my support most.

The supervision was focused on Sera's psychological blocks and issues. As recognized earlier, in session two, Sera continued to identify very much with Jade in repressing her needs for others. Because of this, Sera reflected that she wanted Jade “to succeed” and she became nervous when Jade seemed to “regress”, exhibiting her anxiety over her changes.

5.3.4 Analysis

This session started in high spirits but the mood quickly changed because many difficulties presented themselves: Jade was painfully torn between her wish to move forward and her inclination to give up the changes she had made (affect, difficulty).

Responding to Jade, Sera tried to help Jade to focus on the supportive messages from the music and the drawing (therapeutic intervention) but Jade could not hold down her conflicted feelings toward her changes. Even the same music Jade had once responded to positively, “Hamabe no Uta” (Narita, 1996), could not contain Jade's anxiety.

The difficulties arose when Jade started showing her anxieties (affect) over the changes she had made and how her anxieties were not taken care of (intervention) before focusing on the chosen supportive imagery (therapeutic intervention). There were several problems in the selecting process for the supportive resource (difficulty, intervention, supportive resource). Sera chose the supportive imagery (intervention), the feeling of being alive, soon after Jade started expressing her conflictual feelings about the change she had made, feeling alive as well as feeling like giving up (affect, difficulty). Sera may have intended to draw Jade’s attention to the positive aspects of the change but, by doing so, Jade’s anxiety caused by the change was not taken care of (therapeutic intervention, affect, difficulty). In addition, because the chosen supportive imagery, ‘the feeling of being alive’, was a by-product of the changes, which she felt conflicted about (affect), Jade may have had great difficulty focusing on and deepening any positive feeling from the supportive resource. I wonder if Sera had heard Jade’s conflict, dealt with it and let Jade choose her own supportive resource, how differently her difficulties would have presented themselves.

Both music and drawing (expressive media) reflected and represented vividly the confusion and conflicts Jade experienced (affect, difficulty) (see postlude analysis above). Even though Jade heard an encouraging message, ‘moving forward’, from the music her anxiety was provoked further when the music was played (expressive media,

affect, difficulty): “feeling complicated, like a swirl”, “confused” and “could not focus”

(postlude). Such confusion and anxiety was explicitly expressed in the drawing (difficulty, affect, expressive media): water shooting up from a fountain [moving forward], which was disappearing because of a flood [giving up].

The supervision was focused on Sera learning about her countertransference enacted in the session (relationship). As Sera acknowledged, because she identified with Jade too much (relationship), she “pushed” Jade “to succeed” and she attempted to save Jade from giving up the changes she had made (intervention). Because of these fused boundaries, Jade’s ‘giving up’, regarded as ‘regression’ by Sera, may have felt like a

‘regression’ of her achievement in working with Jade (relationship, affect). The positive change in their relationship was observed only after Sera acknowledged (therapeutic intervention) Jade’s difficulties and anxiety (affect).