A 39-year old woman client presented in therapy with excessive feelings of guilt. The client did not know the aetiology of this invasive feeling that had gradually seeped into all areas of her life. At times she was able to rationally accept that she had no reason to feel guilty, but the feeling still persisted. Previous therapies included cognitive approaches and hypnosis. Both proved useful for short periods of time.
As the intervention begins, the metaphor of how she knows and feels guilt is developed. Shortly after this, the client gives a personal pronoun and a child within is developed in T-1 (see Problem Resolution through Metaphor Therapy – Quadrant II, for an explanation of T-1).
Because the event T, has not occurred when the child’s body is developed , dissociation takes place. It is important for the therapist working with a client whose child within is developed in T-1 to be alert for any opportunity the child may take to disassociate. Disassociation prevents the child from going through T in their body. The child within in this case also has fragments. Notice the elegant manner in which the fragment returns to the child within and becomes part of her again.
This intervention switches quite rapidly from metaphor, memory and childwithin and illustrates how to map the changing locus of attention. It also demonstrates how to make sure all the information that was developed is woven back into the narrative, crossed over and transformed in T+1. A nested child within is also discovered. Be aware of how this aspect of the intervention is recognized and treated.
A Nested Childwithin – Definition
A nested childwithin occurs when more than one childwithin emerges during an intervention. Each nested childwithin developed is younger than the last; an eight-year old childwithin may be developed, followed by a three-year old and then a two-year old.
The original childwithin is the first one developed, and therefore the oldest. A nested childwithin represents an earlier trauma which is not accessible until after the oldest childwithin is developed. The nested childwithin communicates by occupying some part of the older childwith’s body and preventing that child from progressing in the intervention until the younger child is taken care of and freed from their T-1.
A nested childwithin exists when multiple incidents of trauma, which may or may not be similar in nature, have occurred. The nested childwithin is found in the symptoms of the original childwithin.
For example, if an eight-year old child has been developed and experiences symptoms in her eyes, the nested childwithin will be found in the eyes of the eight-year old. The symptom in he eyes of the eight-year old is developed into a metaphor and from out of this metaphor the nested childwithin is found. The nested childwithin actually has custody over the eight-year old’s eyes.
|And what would you like to have happen?
|I would, mmm, like to stop feeling guilty
|Clues to a child within exist between the lines — the ‘mmm’
|And when you feel guilty where do you feel guilty?
|In my chest
|Exploring guilty and T-1
|And when it’s in your chest, whereabouts in your chest?
|In my heart
|And when it’s in your heart, whereabouts in your heart?
|And when it’s all over, it’s all over like what?
|Beginning to develop the first metaphor
|And what kind of pinpricks?
|Like sharp needles digging in
|And is there anything else about sharp needles digging?
|No, they just keep digging
|And what would sharp needles digging like to do, and what would sharp needles digging like to have happen?
|Get bigger and just keep digging
|And what happens next as sharp needles get bigger and just keep digging away?
|They make me sad
|First clue to a childwithin is first personal pronoun ‘me’.
|And how old could you be when sharp needles make you sad?
|And what could seven be wearing?
|A check dress with puff sleeves
|A child can define herself and her environment by what they are wearing
|And is seven wearing anything else when she is wearing a check dress with puff sleeves?
|She has a bow in her hair and black patent leather shoes and white socks
|And what would seven like to do when she has a bow in her hair and black patent leather shoes and white socks?
|She wants to run away but her feet are stuck
|Develop and mature each information form
|And she wants to run away but her feet are stuck. And what happens next when feet are stuck?
|The sharp needles are going to get her
|And as sharp needles are going to get her, what happens next?
|I go up
|Metaphor of dissociation
|And you go up like what?
|And what kind of cloud?
|A white fluffy one
|And what would white fluffy could like to do, and what would a white fluffy cloud like to have happen?
|And can a white fluffy cloud just float?
|And how long would a white fluffy cloud like to float for?
|Just a bit longer…
|And a white fluffy cloud can take all the time a white fluffy cloud needs to float just a bit longer
|Possible clue to a nested child within
|And when you’re scared how old could you be when you’re scared?
|And just little and what could just little be wearing when just little is scared?
|A sundress with boots on
|And is there anything else about just little when she is wearing a sun dress with boots on?
|She has pigtails and sandals
|And what would just little with a sun dress, pigtails and sandals like to do and what would she like to have happen?
|He won’t let her get up
|And when he won’t let her get up, how longwon’t he let her get up for and how long won’t he let her get up and what happens after he won’t let her get up?
|A very long time..
|And how long is a very long time and what happens after a very long time?
|She hides in the closet
|And whereabouts in the closet does she hide?
|Right in the corner
|And she can take all the time she needs tohide in the corner of the closet and does she need anything else when she hides in the corner?
|No, she’s all alone
|And how long is she all alone for and how long does she hide for and what happens after she hides in the closet and after she’s all alone?
|She can’t see if he has gone
|And she can’t see if he has gone when she hides in the corner. And would needles that are sharp be interested in going to help her when she can’t see if he has gone?
|Needles have eyes!
|And needles have eyes and when needles have eyes, what happens next?
|They can see he’s gone
|And they can see he’s gone. And what happens next when they can see he has gone?
|She can get up and walk out of the closet
|And can she get up and walk out of the closet?
|Yes, she wants to get right out of that house
|And can she get up and walk right out of the closet and get right out of that house?
|She wants to
|And when she wants to, what could be the first thing that could happen so she could get up and walk out of the closet and get right out of that house?
|She has to look under the bed
|And can she look under the bed?
|She’s frightened to
|And when she’s frightened to look, couldneedles that have eyes look under a bed?
|Yes, the needles could look
|And what happens next as they look under a bed?
|There’s a little tiny speck
|And what kind of little tiny speck?
|Just a little tiny one
|And is there anything else about a little tiny speck?
|Fragmentation: this occurs when inanimate objects are personified with human feelings
|And a little tiny speck is lonely, and what would a little tiny speak like to do when it’s lonely?
|And can it go outside?
|It’s too small
|And what happens next when it’s too small?
|It needs help
|And would needles be interested in helpinga little tiny space?
|No! They’re too sharp. They would hurt speck
|And would boats on a sun dress be interested in helping speck?
|They could but they need water
|And how could boats have water?
|I don’t know
|And when you don’t know, would heart thathad pinpricks be interested in helping boats have water?
|Heart could cry and cry through the pinpricks and fill the room
|And can heart cry and cry and cry and fill the room?
|Yes, heart has a lot of tears
|And as tears fill a room, what happens next?
|Boats can float and speck can sail right out of that room
|And as boats float and speck can sail right out of that room, what happens next?
|Boats can go back to the sundress
|And what happens next?
|She walks and walks and goes to Aunt Sarah’s house
|And as she walks to Aunt Sarah’s house and she walks and walks and she walks to Aunt Sarah’s house, what happens next?
|She can stay there she’s safe
|And she is safe, and when she is safe there, what would sharp needles with eyes like to do
|They’re not so sharp now.
|And they’re not so sharp now. And they’re not so sharp now like what?
|Like knitting needles
|And what kind of knitting needles?
|Busy knitting needles
|And what might busy knitting needles knit?
|Knit a blanket
|And what kind of blanket?
|Soft and fluffy
|And would a white fluffy cloud be interested in a soft fluffy blanket?
|Yes, it would like to wrap around a white fluffy cloud
|And what happens next when a soft fluffy blanket wraps around a white fluffy cloud?
|She likes that
|And does seven like that?
|Yes. She’s safe, too
|And she’s safe too. And what would Just Little and Seven like to do now they’re safe?
|And can they play?
|And what would they like to play first?
|Seven likes to jump rope
|And it’s been a very long time since she could move feet that were stuck and now she can jump rope. And does Just Little like to jump rope?
|Yes. She’s not so good but seven can teach her
|And what happens next?
|They can have cookies and milk
|And do they like to have cookies and milk?
|And does a heart that had pinpricks need anything else?
|No! It can fill up with warm blood
|And it can fill up with warm blood now they are safe and they have a soft, fluffy blanket. And does speck need anything else?
|No. Speck is just fine
|And speck is just fine in a sailing boat. And do Seven or Just Little need anything else?
|No. They’re fine. They don’t ever have to go back
|And would they be O.K. if you came back here now they’re safe at Aunt Sarah’s and they don’t have to go back?
|Yes, they have each other now
|And they have each other.
Pins and Needles Outline
- Presenting symptoms: pervasive feelings of non-rational guilt
- Want: to stop feeling guilty
- Map epistemological metaphor: 2 component metaphor: a) needles in b) heart
- Mapping reveals Child within
- Define Child age/wearing (7 who is sad)
- Elicit want reveals double bind # 1, “ She wants to run away, but feet are stuck”
- Evolve double bind which involves (T-1) c/w dissociates to prevent c/w going through T-1
- Define metaphor of dissociation: “fluffy white cloud”
- Mapping reveals a nested child within
- Define nested child – just little, sundress with boats on
- Elicit want reveals double bind # 2 (he won’t let her get up)
- Evolve double bind, she hides and is faced with a problem
- Solution: suggest needles (3) as a resource to help problem – evolve attributes of initial negative symptoms to reveal positive function and serve as a positive resource): needles have eyes!
- Evolve scene: he has gone. She now wants to leave (original want 11), frightened
- Ecology check reveals a need to look under the bed. Problem
- Solution: suggest needles as seeing resource (reinforcing positive evolution of function)
- Discovery and maturation of fragment: a little tiny lonely speaker faced with problem (double bind #3) needs help – maturation
- Solution1: suggest needles go: rejected
- Solution 2: suggest boats on dress go to speak (10)
- Problem boats can help but need water
- Solution go to 2nd part of negative metaphor: heart
- Result: a heart can cry and cry tears through pinpricks. Boats can then float out, speck sails out
- Evolve: Boats then reintegrate to dress. Purpose fulfilled (positive alignment)
- This allows for resolution of nested child within. She walks to Aunt Sarah and is safe
- Work with original, negative and as yet un-transformed metaphor needles become knitting needles – create soft fluffy blank (2nd positive adaptation of previously negative resource)
- Product of transformed initial metaphor – goes to dissociated white cloud
- This re-associates original child within
- She goes to play with ‘just little’ – creating integration and re-familiarization of parts
- Ecology/end of session