The Academy for Health Counseling, a Specified Nonprofit Organization

International Journal of Structured Assocoation Technique No.5 pp.7-18

Case Study

A Case Report of Mental Health Improvement of a Marriageable-Age Lovelorn Female by SAT Imagery Therapy

Wen-jie Yang1), Wen-Yan Hu2), Yang Fu3), Qing Guo4),

1jMental Health Counseling Center, Yunnan University, Kunming, China 650091
2) Mental Health Counseling Center, Zhejiang Gongshang University, Hangzhou, China
3) UCSI University
4) Education and Training Section, Political Division of Yunnan Public Security Department,
@ Kunming, China 650000

E-mail (W.Y)

* University Students' Mental Resilience Promotion Intervention Study: New Exploration Based on the SAT Imagery Therapy, Sponsored by Zhejiang Education Scientific Planning Research Project (Project Number: SCG038 )


In China, the public believe that the best stage for a female to get married is between ages 25 and 28. During these ages, this group of females encounters pressures from family expectations, and stressors from social responsibility. They often suffer more negative mental health issues from lovelorn experience than females under 25 years. Their mental world are easier disturbed by external influences. The traumatic early childhood experiences of this group often affect their cognition. The current research estimated the effectiveness of SAT Imagery Therapy in the Chinese culture. The subject was a 25-year-old marriageable-age lovelorn female. SAT Imagery Therapy strategy was utilized to help her overcome the social life difficulties of lovelorn experience. The result indicated that she got better psychologically, indicating that SAT imagery therapy may be effective in the Chinese culture.

@Marriageable Age, Lovelorn Female, Chinese, SAT Imagery Therapy

1. Introduction

@@According to the Chinese law of marriage, females can get married after 20 years old. But in real life, more than 90% of females consider the best marriage age to be between 23 and 26 years. A lot of females think that the chance to get married after 25 decreases gradually. On the other hand, about 65% of males regard females between ages 25-28 as their ideal marriage partner1). They insist that the chance to get married for females older than 28 years drops sharply. As a result of many factors, femalesf marriageable ages are shorter than those of males. Females often feel heavier marriage-expectancy related stress. Expectedly, parents who have older daughters bear higher marriage-related anxiety than parents who have older sons.
@@Worry about future marriage exists among all single women client aged from 25 to 28 years. Compared with 20-year-olds, 25-year-old lovelorn ladies feel much more stress as a result of higher social responsibility and family expectation. Sad experiences when they were younger could affect their later life cognition of reality. Therefore, lovelorn ladies at this age tend to be more sentimental and experience higher mental fluctuations. They usually have more negative self-image and manifest higher suspicious of the world around2).
@@The subject of this case study was a 25-year-old lady who recently had a failed love. After treatment with SAT image-therapy3), her mental condition improved greatly within a short period: both her work and life went really well. It seemed apparent that SAT imagery therapy may have impressive effect even in the Chinese culture.

2. Case Introduction

2.1 Case background

@@Client: A, 25 years old, primary school teacher, and extroversive female (self evaluation). Falling in love with her ex-boyfriend for 3 months, she was being criticized by him and eventually he broke up with her.
@@Mental situationF She felt extreme sadness, lonely and lost her sense of security. She had working stress, experienced noisy work environment, high expectations from school and studentsf parents. She wished to change her job. While growing up with her grandmother, she heard, gI donft want youh and gI send you to someone elseh in her early childhood; lived with her parents for not more 1 year before she became 18; parents were usually quarreling; In her memory, her mother never helped her in her study, but always had high expectations from her; her father always complained about her and had no sense of family responsibility towards her.
@@Genetic temperament factors4): A showed cyclothymia - the desire of getting acceptance from others; the difficulty to deal with aloneness. Adherence - easy to build up high expectation and requirements towards the self or others. Anxiety - easy to get into the feeling of woolgather, pessimism and hopelessness. Novelty - lack of the persistence of repeated work.
@@Behavioral traits factors3): A had self-suppression - high difficulties to disclose inner feeling and desire. Interpersonal dependence - high low self-esteem to make decisionsChigh expectation towards othersChard to get satisfaction. Problem solving - low lack of the resource to deal with the problemCpoor problem-solving skills. Difficulty to feel emotion - high repression of own weakness, hard to feel others' understanding. Self-denial - high inferiority complex of lovelorn experienceCloss of hope for the future. PTSS - highCstressful fetal period.
@@A's Genetic temperament scores showed that she had cyclothymia, adherence, anxiety, and novelty. Her behavioral traits scores are shown in Table1.

Table 1. A's behavioral traits scores
Scale Standard Scores A's Scores
Self-restrain Below 6 10
Interpersonal dependence Below 4 11
Problem solving Over 15 7
Difficulty to feel emotion Below 5 13
Self-denial 0 6
PTSS 0 7

@@It may be observed that A's lifestyle is gother-rewardh; she has the tendency to lose her goriginal selfh. The coping strategy for A is changing her lifestyle from other-reward to gself-rewardh5). The objective of such strategy is self-discovery by enhancing her resilience to other-reward tendencies, which may precipitate increased self-esteem.

2.2 Case Analysis

@@Present stress factors: the feeling of unacceptability and abandonment that A's boyfriend inflicted on her significantly increased her feeling of self-denial and anxiety. Meanwhile, A also had feelings of exhaustion and mental burnout due to factors such as homesickness, competition with others, noisy and crowded environment, high expectations from elders and mal-relationship with her workplace colleagues.
@@Future and past stress factors: The uncertainty about her future career as well as the insecurity from not being married were part of the sources of her stress. Moreover, A's childhood development caused her glove desireh to be unfulfilled and made her to be so afraid of abandonment; thus she formed negative self-image for almost everyone around. In the meantime, A's parents were too quarrelsome to show interest in her studies. They still placed high expectations on her shoulders and complained about her behaviors. Her family had low problem-solving and conflict avoidance tendencies. A feared about quarreling and bore othersf expectation tendencies since her childhood. In addition, A could not obtain unconditional love from her parents, such that she lost her self-confidence and built up her whole life values on othersf expectation. When she failed in her relationship with her ex-boyfriend, her feeling of self-denial increased.

3. Intervention Result

3.1 Counseling Process:

First Session
Date Early December, 2011
Technique SAT listening skill 6)
A's status break up with her boyfriend two weeks ago; unstable mood; low self-esteem; the feeling of fear, aloneness and unhappiness
Objective Understand her feeling and reduce some of her negative response
Result calm down

Second Session
Date Mid-December, 2011
Technique SAT behavior change and support skill 7)
A's status Afraid of self development
Afraid of her ex-boy friend will date a better woman
The main feeling: insecurity & anger
The score of stress: 80%
Negative feeling: fear, unsatisfied, distrust, hate, self disgust
Internal voice: Do not leave me alone, help me
Sad scenery imagination: one day of Afs primary school time, when she was in her grandmotherfs home, she had a dinner with her uncle. She really wanted to have a piece of beef. So she took up her chopsticks and was trying to get that piece of beef from the dish. Suddenly, her uncle beat her hand with his chopsticks and told her that she did not deserve to eat much meat. Eventually, she had to apologize to her uncle.
Comparison between past and current events: the client was not able to disclose her standpoint, so that she could only catch her own feeling of frustration and deliver the unhappy behavior without reason, when her boyfriend could not be with her. One by one, her ex-boyfriend hardly bear her unreasonable response and to be sick of her dependence. On the other hand, once she could not fulfill her need of security, she only recognized the anger from inside herself and ascribed the feeling to destiny.

Action goal:
1. SMS to her ex-boy friend, wish him well. (90% of applied confidence)
2. Take care of herself, do not suspect others. (80% of applied confidence)
Objective The score of stress (after the session): 30%
Result decrease the degree of stress

Third Session
Date April 7th, 2012
Technique SAT temperament coaching and Health Counseling4)
A's status Still have the attachment bond with her ex-BF; feeling low confidence and lonely; distracted her work by lovelorn experience; expected the counseling session
Objective To understand Afs Genetic temperament by herself in order to comprehend the reason of her stress and learn the relevant self-care action.
Result A found some answers to her problems; still feeling not so confident

Fourth Session
Date April 21st, 2012
Technique SAT Self Imagery Adjustment Method8)
A's status More calm down; more open-minded to talk and share; accept the truth and learn how to be independent; more effectiveness of work; have confusion towards the relationship between her and her parents; feel unsure of an intimate relationship.
Ideal Self: Have a strong heart and independent.
Confidence Level: 20%; Ideal Confidence Level: 80%
Spiritual keyperson Imagery Method: Hope to have an elder brother or sister, The temperament of her brother was Cyclothemia & Viscosity as well as his/her sister was Cyclothemia & Autisticism. Once a client had such kind of siblings, he or she would be easier to show open-minded, confident, relax, peaceful and warm feelings.
Universe Self Imagery Method: Hope to be surrounded by golden sunlight and being protected. The favorite action of the client was helping others in order to getting along with them on friendly terms. After achieved her purpose, she felt stable moods such as peaceful, joyful and meaningful.
Objective After 5 years, the confidence level becomes 80%
Result By means of counseling sessions, A realized her weakness attributable to her parenting style. For example, she had high similarities of lifestyle compared with her parents such as hard to reach peaceful mind, to feel empty, self-fish and substance-based. Especially, complaint and finding excuse were apparently inherited from her father. Thereby, she decided to be herself rather than looking forward to others'.

Fifth Session
Date May 5th, 2012
Technique Ideal parents imagery method9)
A's status Achieve the success by applying the counseling outcome towards her parents; more active and effective work
Objective Re-recognize her parents and increase relationship
Real fatherFimpetuous, avoiding problem solving, complaint
Real motherFNo sense of responsibility, donft care of herself
Ideal father: Yan-hong Li, The CEO of Baidu internet companyCskillful, well-educated, rich
Ideal motherFThe wife of Li'sCwell-educated, classic, unique.
Ideal selfFSunny, open-minded, complete personality
The strengths of parents with ideal self versionF
FatherFWorking hard, be responsible for the family
MotherFModel house wife, sacrified everything for family
Result A realized that love come from heart; everyone can feel; every parent has their own difficulty; no one is the worst.

Sixth Session
Date May 19th, 2012
Technique Human relationship Adjustment Method4)
A's status Less the complaint towards her parents, transfer the focus on her work.
Objective understand self and others, know about how to build a good relationship
Target person: partner in work
The score of interpersonal relationship: -1 to 2
The score of stress: 70% to 50%
Result A realized her over-expectation to her working partner. Furthermore, A also realized her ex-BF did the same thing to her that made her feel down and low self-esteem. Therefore, she decided to let the previous intimate relationship go, respect herself and other, focus on the future as well as re-believe in good love.

Seventh Session
Date June 2nd, 2012
Technique SAT Communication Skill10)
A's status Stable mood, focus on work and the willingness to know more about communication with others
Objective Learning communication principles and skills
Result A felt the touch with her real life and contact skills with her current job. A also build confidence to her life as well as being more independent.

Table 2: A's behavioral traits scores change after SAT counseling
Scales Standard Scores Before 3rd After 4th After 5th After 7th
Self-reppression Below 6 10 2 3 3
Interpersonal dependence Below 4 11 3 5 2
Problem solving Over 15 7 10 11 15

3.2 Counseling Evaluation

@@After the 7th session, A had obvious changes. She became effective in her work, re-built her self-esteem and confidence. After two monthsf post-therapy sessions, A completely walked out the shadow of her lovelorn experience. She maintained peaceful mood and focused on her work. She could get value from her current job as well as benefits from a good social relationship.
@@Regarding future intimate relationship, A was still worry about some real issues such as her age, the personality of her partner as well as her relationship with her parents. However, A understood how to deal with these issues with a peaceful mind. During the phone-call counseling, the counselor emphasized what A already achieved and encouraged her to believe in herself, and keep on in the right direction. A felt warm and happy.

4. Discussion

@@Females who are between 25 to 28 years old face critical psychosocial decision-making issues in China. Their careers and marriages are often endangered. The interaction between their future expectations and un-finished businesses in the past are serious stressors that often make them confused. When they experience unexpected incidents such as divorce, they could suffer complete down moods and may not objectively evaluate the real situation. They transfer their inside weaknesses to others and get weaker and insecure. In addition, the social support system may have significant impact on them. A was an obvious example.
@@Nowadays, in China, there is a big competition for stable job11). Most graduate students would choose big cities in order to get more opportunities rather than choose what they genuinely like and can do. For example, majority of the students believe that working in government is the best choice. They decide to look for government job in the city and ignored their own emotion towards their hometown and family. Unfortunately, they often experience a lonely life in the city resulting in some unexpected psychic challenges, they feel frustrated, anxious and disappointed. They deeply ached for care and understanding from others instead of confront their own wrong decision-making. Thus, lovelorn experiences cause a big crash in their lives. A was an obvious case.
@@The education system in China is examination-oriented rather than focus on the self-development of children and their social ability12). However, parents usually make efforts in developing the social-self of their children. Some parents such as A's reflect their unfinished hope in their children. Therefore, some children could not get the correct coping strategy to deal with their own life problems. A few parents even distressed their children by parenting in the improper way, such that the children may feel angry and disgusted with their parents. Eventually, such children hardly trusted others in the adult world and could have low skills to deal with their self-emotions and moods.
@@In this study, A had other-reword lifestyle which had the tendency to lose her goriginal selfh. Her lovelorn experience caused a lot of knock-on effect to distress her. SAT Imagery Therapy strategy matched with her problem, especially in helping her recognize her true self and re-build her confidence. Her case was effectively processed. After all the sessions, A's mood significantly leveled out and transferred to gself-rewardh. Her subsequent actions such as continuous learning, communicating in the proper way as well as making efforts for self-care was attributable to the SAT therapy outcome.
@@Currently, there is a big dilemma in terms of counseling mechanism in China13). The clients focus on whether or not its cost matches its effectiveness. They wish the counselor could solve all of their problems as quickly as possible. They have high expectation of each counseling session. If the particular session could not bring them the big change, they would feel strong sense of helpless and powerless such that they lose in the counselor. SAT Imagery Therapy seems to resolve this problem. It is a short and result-oriented approach. The client could easily perceive the effect of each session. It quite matches with current Chinese demand situation. Therefore, SAT has a bright prospect of development in China. The therapy has other high-technique methods such as SKP Imagery Technique and the Three-Generations Imagery Technique. These techniques circumspect the traditional counseling methods to sufficiently empower the client for the in-depth self-awareness and resolution of his/her problems.


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