Case Study 1:Intimacy in Relationships

Liz came to therapy with relationship problems. She found herself avoiding intimacy with her husband while admitting that all her relationships had always been difficult. She couldn't seem to feel close to anyone. She had come from a home in which the parents had frequent fights before the divorce when she was eleven. Her brothers teased her constantly and during childhood she had frequently suffered from night terrors.

I had been seeing Liz for approximately 5 months on a once a week basis. We had had an equal amount of GIM and talk sessions. She had learned to trust her inner wisdom and the metaphoric way in which the imagery expressed her feelings.

She was miserable as she came for a session on this day. She and Rob had had a bitter argument, he was fed up with her aloofness. I suggested we explore the blocks in the relationship as the music of Bach began. She saw herself in a park with her husband approaching.

She couldn't face him. She felt too ashamed. When urged to explore that shame she became aware that she was wounded in her genitals. She knew that only a pure white light could help her, but she was cut off from the light. As she looked more closely she saw that connected, yet separate from the wound was a pure, innocent child. The child had somehow split off from her and was hiding.

Within this scene there emerged the form of a defender. This defender looked like a haggard, frazzled form of her adult self. It informed her it was tired of constantly standing between her and anyone who would get close to her. It had been doing all this to protect the child.

With my urging Liz was able to ventilate all the pent-up feelings of the worn-out defender. She raged and cried. Finally she indicated it was over but now she was seeing the one's who had started this wounding. In her mind's eye she was back at the beach as a five year old. She was at an outdoor evening concert with her family. She remembered she had gone to the bathroom alone.

The boys jumped her as she came in the door. Threatening to kill her if she told she was raped by each of them. By briefly re-experiencing the trauma of this event she was able to release it. As this occurred a bright light appeared in her inner world filling the void and healing the wound. Suddenly the child found herself transforming into Tinkerbell (a child woman) while her shadow was sewn back on.

Returning to her normal state after this music session she was amazed at what had occurred. She had never connected the rape with her hesitancy in relationships. She was not aware that she still carried the shame from that long ago event. The fear had lodged deeply in her psyche, she was overly protective of her emotional attachments.

This one session had an enormous effect on the intimacy problem with her husband and she felt it helped to save her floundering marriage. After 10 years they are still happily married.

Case Study 2: "The Bottomless Pit"

Mary was an attractive 35 year old redhead who was married and had a well paying job as a computer consultant. Her appearance belied her inner turmoil. Previously, she had tried conventional talk therapy for her feelings of depression but felt frustrated that her " insights" had not produced any real change. She sang in the community chorus and was intrigued that somehow music could be used for counseling. Because she loved music, she decided to give it a try and committed for 12 GIM therapy sessions.

Her initial imagery revealed that there were 2 Mary's - the competent career woman/ dutiful wife contrasting with carrying on a secret affair and more than occasional drinking which was getting harder to hide. Her overriding feelings were of loneliness and guilt.

During the course of her GIM therapy, significant images revealed a foreboding cave, a faceless cheerleader, a sad little girl, the appearance of angels, a bottomless pit in her stomach, and a bridge of indecision. The music helped her connect with her feelings by triggering memories that had been frozen in her mind. In her third session, we began to see the dynamics that contributed to her aloneness.

As Mary lay relaxed on the couch, the music from a Bach fugue evoked a sensation of spiraling downward. Though she felt apprehensive, she reported, "The strings say I need to go down to that cave and go in." There in the hidden recesses of the cave, she encountered her brother who, years earlier when she was eight years old, had committed suicide. "How could you have done this to me?" she cried out in anguish, "You were my best friend!"

Music selections for grief work encouraged Mary fully to feel the anger and abandonment she had stuffed down deep inside. Afterwards, Mary was amazed that her loss from long ago could be so filled with emotion and so real. She thought she had dealt with her brother's death "long ago". The next few weeks, Mary's frozen feelings began to "thaw" and she was more ready to face what she called "how my life is a lie".

In her sixth GIM session she reported that she had been arguing with her husband Bill and she just couldn't trust him with her feelings. She felt impelled to keep her secret affair going, though she suffered from guilt pangs. I used the nurturing music of Britten, Vaughan Williams and Berlioz , as she explored her life in a session she later called "The Bottomless Pit". Sharing her imagery, Mary reported, "The sky is brilliant blue, the scent of Fall is in the air. I hear the crowds cheering. I'm sixteen in my blue and gold cheerleader outfit at the game. Tommy, my boyfriend, just made a touchdown. ... I look excited and bubbly on the outside, but on the inside I know something is wrong." As I look at myself, I don't have any face!" she exclaimed. I encouraged Mary to continue sharing as the sixteen year old. "I look happy", she said, " but on the inside I'm hollow and split". I asked her to try to explore her feelings. Mary softly cried, "I want to be whole and stop hurting ..."

At this point, the melancholy yet tender melody of the music was encouraging Mary to stay with the wounds of the past. " I am slowly sliding down into that black hole in my stomach now," Mary said in a resigned voice. "It's that familiar feeling again - the bottomless pit place." Mary wept, "I have no heart, no soul - I'm just empty ..."

Later in the session, as her tears subsided, Mary was able to take the music with her into the hole. Lovely voices from Puccini's "The Humming Chorus" from Madam Butterfly seemed to caress her, and she felt their gentle harmony as angels of mercy.

Mary's face was relaxed now. "They're comforting me" she whispered, " And the darkness is beginning to lift. They are telling me that it's going to be alright ... I'm going to bring the sad little girl [herself at eight years old] and the cheerleader in here with me so I can let the angels love them too." "They are singing to us. I feel their light", Mary sighed deeply, "I'm ready to come back now."

In the weeks afterwards , we discussed the significance of the imagery. Mary was struck with the 16 year old bubbly cheerleader and the hollow feeling on the inside. "It's like the mask I still wear today," she mused, "living a secret life."

Mary had grown up in a family where her father would often drink and her mother was aloof. Kids were to be seen and not heard. having friends over was discouraged, and Mary remembered getting good at making excuses. The family rule was to "look good", and Mary's job was to be popular and make good grades.

In the imagery sequence, Mary had found a way to face her deep childhood wounds of isolation and feeling split, and was able to begin to allow herself the comfort and caring that she never felt from her parents. Even though she did not consider herself religious, Mary accepted the angel helpers without question.

Gradually in the weeks that followed, Mary felt like she was more aware of her reactions and behaviors. She wondered if she could trust more, yet was still churning over her affair and all the secrets in her life. She also saw her daily cocktail hours as a way to "numb out" the hollow feelings in her current life.

In her eighth session, Mary titled her imagery "The Bridge of Indecision ". She found herself stuck in the middle of a bridge surrounded by a barren landscape, and could not move. "I can't decide whether to go back to Bill or leave him for my lover," she lamented. The music mirrored her ambivalence as the melody and rhythm swayed back and forth. "The affair is over," she admitted quietly, "but I don't know if I want to be with Bill." The feeling of stuckness intensified. "This can't go on," she moaned, "I have got to move!" To the strains of Brahms' Piano Concerto, the scene shifted to an old fashioned ballroom filled with dancers. To her surprise, she and Bill were dancing, feeling the rhythm of their movements in tune and time to the music. "We used to do this back when we dated," she exclaimed. "I forgot how natural we could be and how much fun it was."

Afterward, Mary stated she felt relieved to say her affair was over but felt scared to end it for once and for all. "Am I really getting an answer from myself about all this?" Mary wondered.

During the following week, Mary's homework was to use the dance image as a metaphor for exploring some risk taking with Bill. Could things between them really be different? Could she open up more and tell him her real needs?

In the weeks that followed, Mary made some critical decisions to end her affair and seek out couples counseling with her husband. She felt she could at least trust her own instincts and give the marriage another chance.

Mary called her last session " Reunion ". Finding herself once again in the dark cave where she had grieved over her lost brother, a curious thing happened. She relayed, "I see a pool of water with ripples on the surface. ... It's the kind you want to get into." She fell silent and then continued, "There is a kind of glow coming up from down under. It is sort of a diffused light coming up through me and all around me. It's wonderful!" she exclaimed. Later, during Wagner's exquisite masterpiece "Lohengrin", Mary closed the session with a memorable reunion. "Ted, my brother, is here," she declared. "We are holding each other. He says he is proud of me. I feel so grateful. There are no words."

Today, Mary regards herself as a different person. She states that she is much more open emotionally and willing to try new things. She feels much more confident and reports that she and Bill are getting along much better. They actually signed up for ballroom dancing classes, something they had always talked of doing. To mary, GIM therapy was amazing. The dark cave, the sad little girl and the faceless cheerleader, the bottomless pit in her stomach, the angel helpers, and the bridge of indecision were powerful metaphors which told the story of her life. The images contained the wounds of the past and the present, yet also held the treasures and her strengths to be the real person she longed to be. The music was her constant companion, urging her forward, mirroring her pain, giving comfort. Today she is free to grow, to risk, and to love - no longer split or stuck but free to make choices and take chances trusting herself and others.