A counseling case study on the effects of emotion-focused reflected image meditation on depressive emotions in middle-aged women

A single-case study of a middle-aged woman with childhood emotional deprivation, sexual trauma, bereavement, and chronic conflict with her mother-in-law found that six sessions of emotion-focused Reflected Image Meditation (RIM) reduced depressive symptoms by 48.6% on the Burns Depression Checklist and stress-related symptoms by 31.8% on the Stress Response Inventory. Qualitative analysis of transcripts, drawings, and process notes revealed a progressive emotional shift “from suppression to integration” as the client encountered inner figures representing unmet needs and shame. The authors propose that emotion-focused RIM facilitates the release of suppressed emotions, self-compassion, and emotional integration in middle-aged women with chronic depressive affect.

Study at a glance

Abstract

Purpose: This single-case study explored the effects of emotion-focused Reflected Image Meditation(RIM) on depressive affect in a middle-aged woman with a history of childhood emotional deprivation, sexual trauma, bereavement, and chronic conflict with her mother-in-law. The aim was to examine how biographical wounds and reactivated emotions in adult relationships could be processed and transformed through imagery-based intervention. Methods: The client received six sessions of emotion-focused RIM. Qualitative data (counseling transcripts, therapeutic drawings, and researcher process notes) were analyzed thematically, and quantitative change was assessed using the Burns Depression Checklist (BDC) and the Stress Response Inventory (SRI). Results: BDC scores decreased by 48.6% and SRI scores by 31.8%, indicating substantial reductions in depressive and stress-related symptoms. Qualitative analysis showed a progressive emotional shift “from suppression to integration” as the client encountered inner figures such as “the self in need of care,” “the self hiding in shame,” “the self longing to be loved,” “the self burdened by mother’s load,” and “the self afraid of separation.” Conclusion: Emotion-focused RIM on appears to facilitate the release of suppressed emotions, the emergence of self-compassion, and greater emotional integration in middle-aged women with chronic depressive affect, suggesting its clinical usefulness as a focused intervention for core depressive schemas.