Hajime Eno

Trauma-focused therapy is a common approach for clients with complex psychological injuries caused by a harsh upbringing. However, the effectiveness of psychodynamic therapy warrants further examination. This paper presents a case study of psychotherapy using images for an adolescent female client who had a harsh upbringing. Throughout her life, she appeared to have survived harsh environments by suppressing her emotions and feelings of vulnerability, as well as avoiding interactions with others. Through working with dreams in psychotherapy, she experienced a profound transformation, gaining the ability to distance herself from violence, express genuine emotions, and form meaningful connections with others. This case suggests that psychotherapy using images has the potential to enhance the overall quality of life for clients with a harsh upbringing, beyond addressing the trauma itself. Further accumulation of case studies of psychotherapy using images is needed to expand understanding of this approach.

The term “psychological wounds” is used contemporarily in daily language beyond the concept of PTSD. In the process of psychotherapy for “psychological wounds”, the treatment model is often based on “identifying” the “cause” behind the trauma and “removing” or “repairing” it. However, especially for children in a foster home, this model has its own limitations, such as overlooking the individuality of the client’s experience. Therefore, this article examines a case of play therapy at a foster home from the perspective of the Jungian intrinsic approach, based on understanding the effectiveness of treatment by “approaching” the wounds rather than “removing” them. The first image expressed by the client showed a way of avoiding “being hurt” and “harming someone”. However, when the therapist shared the client’s “wounded image” and was deeply involved in it, the client was able to accept his own wound and became able to relate to others as an equal.

In play therapy at a foster home, intense and cruel images often appear in children’s play. The goal of this article is to understand these images using an intrinsic approach by reporting the author’s perspective. This approach does not consider the images as external items that arise from past experiences or family background. At first, a “sand spiral” made in sandplay was viewed as expressing the client’s vulnerability of being in a “psychological container” and ambivalent feelings towards maternity. However, the author carefully and repeatedly accepted the client’s pretend-torture play with accompanying intense violence, and gradually the client understood how to play on an equal footing and internalize his conflict feelings. This suggests that it is important for therapists to engage fully with children’s images, even if they are violent, and to understand the images in an intrinsic way.