Thus, in guided imagery therapy, the main instrument of transformation is not the word but rather the image. The RIME intervention, which integrates relaxation techniques, guided imagery, and elements of spirituality, uses a symbolic and transpersonal approach. This article refers to the postdoctoral research of the first author and presents the study on the benefits of RIME for patients with the possibility of a cure.
The intervention was applied to women who had undergone mastectomy and were receiving treatment for breast cancer with the possibility of a cure. The inclusion criteria were as follows: patients with the possibility of a cure; patient who underwent mastectomy; patients undergoing breast reconstruction and adjuvant treatments; and patients without psychiatric history, according to their own reports.
The six referred patients were not included in the study since they did not accept the invitation for the following reasons: three patients said they did not have interest in psychological research; one patient said she did not have time to take part in the study; and two patients said that their caregivers could not wait for them to participate in the psychological intervention.
The refusal occurred before they were informed about the specifics of therapeutic work carried out at ICESP. Half of patients in each random group were placed into the control group to receive up to twelve sessions of Brief Psychotherapy BP , carried out by one of the co-authors 4 of this study. The BP described in short in this study has a particular focus and a limited number of sessions, which were carried out through verbal expression.
Their level of education ranged from illiterate to doctorate degree, and they were aged between 33 to 59 years. The patients had had simple mastectomy either right or left or bilateral mastectomy; they had undergone immediate breast reconstruction with a tissue expander or abdominal flap. Only one patient was undergoing outpatient treatment before having reconstruction surgery. All patients in the study underwent adjuvant clinical treatments. It was concluded that the sample of twenty-eight patients was large enough to meet the study goals, including the exclusion of three patients from the RIME group and three other patients from the Control Group for personal reasons that were not related to the religion of the patients.
They were excluded due to time conflict and their availability to participate in the intervention sessions. It is worth mentioning that the clinical treatment of these patients and the possibility of scheduling the ICESP standard Psychology Service were not affected by the loss of participants.
This research method was comparative exploratory and descriptive, and quantitative and qualitative approaches were used. The qualitative results were analyzed using consensus analysis carried out by a group composed of the principal researcher and the co-authors 3, 4, and 5, who have extensive knowledge of Analytical Psychology, Hospital Psychology, and Psycho-Oncology.
The quantitative analysis was performed using the mixed-effects model. Elias et al. The instruments used in the collection of qualitative data were recorded semi-structured interviews and graphical representations, prior to the 1st and after the 3rd RIME sessions. Although the quantitative results have been published in another article Elias et al. The quantitative instruments used to collect the quantitative data, i.
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The application of the RIME started with exercises to induce of a state of mental relaxation through, slow deep breathing and listening to soft music previously chosen by the patient. The RIME intervention includes four basic possible archetypal images that are associated with the phases and operations of alchemy Jung, b and refers to the Symbols of Transformation Jung, The suffering mentioned and chosen by the patient is dissolved; 2 Colorful tunics, through which the patient experiences them all and mentally chooses the color of the tunic they prefer, with reference to the colors of the chakras postulated by Oriental traditions.
Symbolically, the movement of progression or regression of libido is observed and the transcendent function is elicited Jung, Then, through the third image, coagulatio is performed to reach citrinitas. The quality chosen by the patients is coagulated with their well-being and quality of life. Finally, through the fourth image, the coniunctio is performed to reach rubedo.
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It was not possible to work with spontaneous images due to the limitations of the hospital environment and the reduced time for the sessions. If the dark and threatening aspects emerge in the spontaneous images, there was no time to address these issues. The guide imagination is performed. The patients experience each image according to their subjectivity, but these 4 images guide the imagination of the patient for the integration of the creative and loving potential.
The guided imaginary technique is used instead of the active imagination technique due to the fact it is a hospital environment, and thus the sessions must have a beginning, middle and end. The four images of the RIME intervention are guided and not produced by the active imagination to prevent the activation of the complexes by the spontaneous production of images by the patient, because in the hospital environment there is not enough time to address these complexes.
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According to the report of the patients, the RIME Intervention is experienced by them in the symbolically way and in the transpersonal way. Upon completion of the experience, when the patients symbolically prepare to return from the star to the place they were before a flower garden with a small waterfall, a serene lake at the base of the mountains, a quite river cutting through a field, or a tranquil beach with calm sea by going down the white staircase, they receive a blue cloak, which symbolizes protection.
The average length of this experience session is 25 minutes, plus the time required for verbal expression before and after the application of RIME. In the RIME Group, three RIME sessions were performed by the principal researcher with each patient, with at least one week interval between sessions, followed by up to twelve sessions of BP that were performed by the co-author 4. In the Control Group, up to twelve sessions of BP were performed by the co-author 4 with each patient.
The BP was completed when the patient and the psychologist believed that the proposed focus had been sufficiently explored. According to the statistical analysis Elias et al. The improved well-being considering the distress focus Visual Analog Scale was significant in the RIME Group from poor well-being to good well-being , as well as in the Control Group from unpleasant well-being to good well-being. Qualitative analysis of the data indicated that the main suffering, the focus for the transformation of the women with breast cancer in the RIME Group, was caused for the need for self-valorization, which was also observed in the BP in the Control Group.
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The main psychological changes found, mediated by the symbolic elements of RIME, were: 1 Transformation of the feminine representation from an absent or devourer representation into a loving or protective one. These representations in the women refer to the personality structure, and the feminine representation is associated with the main personality with characteristics related to the feelings and intuition Eros , and the masculine representation is associated with a sub-personality personality known as animus, which operates at an autonomous and less conscious level with characteristics related to rationality and objectivity Jung, a.
The Divine representation refers to the connection of the personality with the sacred Jung, a. The transformation of these basic personality structures indicates a healthy restoration of libido Jung, , changing from the death drive to the life drive, enabling integration into the consciousness of the capacity for self-care, self-worth, self-confidence and of deserving of the protection of Divine love, of the existence of internal resources, and of new external possibilities for self-potential expression. The aim of this study was to use the RIME to elicit the transcendent function, that is, to facilitate the integration of the healing and constructive potential of the patients into the consciousness, extending the capabilities of self-worth and positive action, and strengthening their personality through the symbolic union of the opposites Jung, , a, b, , The colors of the tunics were defined by the first author based on the colors of the chakras in reference to Eastern tradition.
An analogy was made between the color of the chakras and the movement of progression or regression of libido, as well as the integration of the psychic polarities through the Transcendent Function. This association between the color of the tunics and the movement of progression or regression of libido with or without the Transcendent Function was a proposal developed by us, the researchers. This was achieved by observing the category found in the symbolic analysis of the colors of the tunics, i.
The gifts offered by the Spiritual Being of Light in the red box symbolically represent the unconscious message to the conscious, as follows:. Carpet full of stars of all colors. Crown with shiny stones.
Crown full of green stones. Golden crown with emerald stones. Two crystals. Red roses. Bouquet of flowers. Pink rose. Orange rose. Feeling of emptiness. Shining red breast. Golden heart. Reassuring message on a paper drinking straw. White robe.
Photographs of places, family members, and acquaintances, making reference to the future and happiness. The graphical representation aimed to identify feelings, emotions, or thoughts resulting from the disease at the moment of diagnosis and during the ongoing treatment breast reconstruction and adjuvant treatment process and to observe the transformation of these feelings after three sessions of RIME.
In the consensus analysis, the authors observed in the symbolism that there was an improvement in drawings of all patients, suggesting that this intervention facilitates the awareness of self-healing abilities and minimizes traumatic memories. With regard to the interpretation of the drawings, there are several possible analyses. These analyses were not carried out with the patient because such therapeutic approach would imply in a long-term therapy.
The analysis of the drawings was performed through a consensus discussion among the author, the three qualified co-authors, and a Jungian analyst who is a member of the International Association for Analytical Psychology. The major focus of this consensus analysis was the feeling that the drawings gave us and on the association of the drawing with the psychological focus of suffering, which had been previously established between the therapist and the patient.
Below is a description of a case of a patient as an example of the consensus analysis performed by the main author and the co-authors 3, 4, and 5. Case 1: Marr, 49, marital status: separated; two children, 25 and 22 years of age living with her; education level: high school; profession: maid; religion: Kardecist spiritualist.
Cancer in the right breast; mastectomy and immediate breast reconstruction with a tissue expander; and radiotherapy adjuvant treatment.
The Focus chosen for the Transformation was the desire to modify the feeling of abandonment by the boyfriend; the very large void left by this abandonment. Answering the direct question about this drawing asked by the psychologist, the patient said that there was no change regarding Jesus for her the Spiritual Being of Light chosen by this patient. This also indicated the facilitation of the connection between the patient and the male figure in an affectionate way, filling the void left by the absence of a male figure.
The colors of the tunics chosen in the 1st session were violet, in the 2nd session it was yellow, and in the 3rd session it was white, suggesting that the transcendent function was elicited, with progression of libido. In the consensus analysis carried out by the authors regarding the symbolism of the gifts delivered by the Being of Light in the red box, as mentioned above, it was considered that Love could represent the union of opposites, the fundamental drive of being, entering into consciousness. The tulip is a flower shaped like a chalice, and it symbolically represents the passive feminine principle; the tulip received in the star from the garden where she started the experience with the RIME in the first image, and its color is a mixture of red, yellow, orange, and white, symbolically representing the integration of divine love with earthly love and confidence in the divine protection of this love; the balance between the libido and the sacred.
The crystal is the middle ground between the visible and the invisible and therefore the union of opposites. The patient and her boyfriend each received a crystal, representing the totality; the integration of the feminine and the masculine; the material and the immaterial. The gifts received in the red box suggest the representation of symbols of Self- Transformation towards healing and wholeness, indicating that there was a psychic movement for the integration of the divine love with earthly love and the confidence in the divine protection of this love; the balance between the profane and the sacred; the manifestation of a middle ground between the visible and the invisible and therefore the union of opposites.
Before the RIME Figure 1 a : the patient reported that at the moment of diagnosis she could not deal with anything. She had felt the same thing when she found out she had a myoma 7 years earlier, and she was very scared. She made the drawing in Figure 1 and said that this yellow building expressed her feelings: she had cancer and she had not yet purchased her own home, and therefore she felt she was in debt to her children.
After the RIME Figure 1 b : the patient reported that at the moment of diagnosis she could not deal with anything. She felt intense frustration at not having done something she had planned for the children, the purchase of their own apartment. Instead of giving her support, those who were close to her said that the SUS does not work.
She missed some people that had distanced themselves from her. She believed that her cancer was just an excuse these people used because they wanted to get away from her. She felt the lack of interest of her friends, who had always included her in their lives, and also of her boyfriend who did not desire her anymore. She had felt abandoned the same way before, when, at the moment of diagnosis, a man who had been flirting with her disappeared when he learned she had cancer. As shown in Figure 2 a, she drew blue clouds, the sun, and a yellow moon, red and yellow flowers, a tree, and a smiling angel.
She said that she tries to think about good things rather than the cancer, such as: flowers, trees, the sun, the full moon, and angels. After the RIME Figure 2 b : the patient said that breast cancer has been a life lesson for her helping her to wake up every morning and move on. She stated that her cancer was not a problem; it was a test and that she was still being tested; she never saw cancer as a punishment, but she believed it was a test. She had never felt like this before because she was rebellious, she did not have much spiritual knowledge and patience.
As shown in Figure 2 b, she drew three flowers, a large red tree and two small ones, pink and violet. She also drew green grass, brown dirt soil , and a green tree. The authors carried out a consensus analysis of the moment of diagnosis, based on Jungian theory. The patient had difficulty in accepting the disease, using denial and the defense mechanism of repression. She used a building to represent a project that she would like to accomplish, and the diagnosis was identified as an interruption of this project.
The building drawing suggests bars, representing the interruption of the movement of libido, implying a type of prison due to the breast cancer diagnosis. The graphical representations and the statements after the RIME still indicated sadness; however, the defense mechanism projection, which is less primitive, was used.
Furthermore, the patient demonstrated dealing with identity, as she drew a face, indicating that she had begun to express her frustrations and a period of mourning due to her breast cancer diagnosis. In both drawings, the one before the RIME and the one after three sessions of RIME, there was a predominant feeling of rationality, indicated by the fact that these drawings were made on the left side of the page.
The drawing, despite having seemingly positive symbols colors and elements drawn , shows a decrease in libido, signaled by the way the dirt was drawn, and it also reveals disorganized traits and a generally childish aspect, suggesting feeling expressions based on fantasy. No, you will enjoy unlimited free shipping when you have the total amount for the added fulfilled by Souq items to your cart is above or equal EGP.
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