Reframing Motherhood within a Jungian Approach to Snow White: A Research Case Study Using Guided Imagery and Music (GIM)

Abstract

The transition to becoming a mother carries challenges to role, identity, and self-image. Myths and archetypes related to motherhood connect societal and personal expectations with individual experiences. The fairy tale “Snow White” emerged within a single session of Guided Imagery and Music (GIM) therapy for a young mother in the postpartum phase. Although previously written up as a clinical case report, this example is now explored as a research case study, which is seen as a unique case with intrinsic qualities and explored via an explanatory approach. The systematic methodology developed for this research case study follows a typology of eight key elements of the Snow White fairy tale, comparing this pattern to the individualized narrative of this young mother. In doing so, variations to the original tale are explored in light of Jungian interpretations, which inform the experience of motherhood. In doing so, this contributes to a further understanding of the changes in role, identity, and self-image experienced by the new mother undergoing both outer and inner change, where the new mother works to fully reframe themselves into their new motherhood role. By understanding this change, additional support can be offered broadly to women during this important transition, and in turn, influence the experiences of current and future generations.

1. Introduction

By applying a contemporary research case study approach, this article explores the client’s experience of the change of motherhood by revisiting a previously published case report [1]. This case exemplified a whole fairy tale emerging in a single clinical session, of which few examples exist in the therapy literature. The metaphorical nature of myth and fairy tale can be well understood within a Jungian approach, and in view of this, the case remains a unique and seminal case for gaining deep knowledge and insights about the client’s inner processes. The ongoing currency of this unique music psychotherapy clinical case report is demonstrated by the ongoing and consistent interest generated through standard research platforms and clinical practitioner responses across Jungian and broader health practitioners. Additionally, more literature focusing on the deep issues surrounding motherhood has emerged since the publication of the original case report article. Therefore, applying a contemporary research case study approach to revisit and re-examine the issues raised provides further learnings and insights relevant to current understandings and practice in addressing the many changes engendered by the experiences of becoming a mother.

1.1 The nature of motherhood

The transition to motherhood after childbirth for first-time mothers (primaparae) involves not only initial physical but also emotional and psychological changes in the months following birth [2, 3]. This period may be named matrescence, “the time of mother becoming” [4], with this term depicting the transition to motherhood and the sense of the “birth of a mother” [4, 5, 6]. The concept of matresence covers the physical, emotional, hormonal, and social transitions to becoming a mother, which may also be considered a “rite of passage” [4, 5]. This builds on mental shifts in identity during pregnancy and the psychological birth of a mother after labor and delivery, where a new motherhood identity is formed [6] through caretaking and ritual [4]. A postpartum metamorphosis occurs in an unfolding “blueprint” plan as anticipation and expectation meet reality [6] and family roles and interactions change [4]. Even the role of the baby within the extended family system may need to be reviewed [6], and the baby acts in a transformative role in maternal psychological development [7].

Feelings of maternal attachment often develop gradually [8] and are related to parenting confidence. First-time mother talk about the impact of the child on their sense of self and becoming selfless in the bonded relationship, with one first-time mother stating, “in order to be the mother she wanted to be, she had to make changes to the person she had become” [9]. Mothers construct their own identities related to self-perception as they change to become a mother after the birth of their first child, which is related to their identity as a woman, the myth of perfections, apparent negativity towards mothering, and conflicts in maintaining what they saw as “the real me” [10]. Not only this, but women’s experience of their physical body during pregnancy and after birth undermines body image satisfaction and sets up an incongruence between mothering and wife/partner roles, affecting perceptions of satisfaction with their own body self-image [11].

In fact, changes in self-concept for first-time mothers flow through from early pregnancy right through to the time of birth and include themes of control, support, and forming a family [12]. A conceptual analysis of the defining attributes of the maternal role results in four attributes which are: nurturing, protecting, caretaking, and managing household affairs [13]. Within this typology, the maternal role can lead to the balanced fulfillment of multiple roles, maternal role strain, and role conflict [13]. Further, results of a meta-analysis suggest that maternal transition incorporates the disruptions of changes to engagement, growth, and transformation of commitments, daily life, relationships, “self”, and work [2]. The theme of self incorporates facing the past, facing oneself, and coming to feel like a mother, and relational well-being also needs to be addressed [14]. Previous experiences need to be acknowledged, including losses and the conflicting emotions inherent in daily mothering activities [2]. Creative techniques which address the embodiment of mothering and its implications for mental health care can assist with anxiety, frustration, and insecurity of first-time mothers [15]. Creative approaches to harnessing myth and fairy tale may support inner personal change [16]. Additionally, the experiences of first-time mothers can be explored through the use of imagery within an existential framework [17].

Clearly, there is a need for psychological support and care in the transition to motherhood. This transition has been described as a time of crisis, in that it leads to re-examination of the person’s life in terms of values, beliefs, and own selves in order to make sense of what has happened and to start to see their lives in new ways [18]. Some first-time mothers may face additional challenges, pre-existing at the time of birth, such as anticipating and/or coping with a pregnancy affected by infertility treatment, high-risk pregnancies, bereavement, ectopic pregnancy, previous miscarriage(s), and so on. In fact, problems with fertility related to getting and remaining pregnant may affect the developing relationship between the child and the mother after birth, and issues around the resolution of previously unsuccessful pregnancies may contribute to conflicted feelings during pregnancy and consequently negatively affect self-efficacy in motherhood [19]. Further, a previous traumatic bereavement of a child/pregnancy can create a lifelong “emotional scar of loss” for the mother [20], affecting the interactive mothering relationship with a “replacement child” [21].

A previously lost pregnancy can also have an effect on motherhood related to subsequent pregnancies and childbirth. Even more broadly, new mothers are in a state of flux and need to deal with multiple uncertainties and unresolved meanings during this transition; they many need to courageously address unresolved experiences to continue to relate to their child [22]. Psychological distress after perinatal loss due to miscarriage or stillbirth is common and typically leads to a range of coping mechanisms by the woman in subsequent pregnancy, which may impact on maternal-fetal and consequently maternal-child relationships [23]. In fact, a high proportion of women may experience elevated levels of ongoing posttraumatic stress, anxiety, and depression after early pregnancy loss such as miscarriage and ectopic pregnancy. These effects may remain longer after ectopic pregnancy than miscarriage, and further work is needed in identifying and treating affected women [24, 25]. In addressing postnatal depression, the importance of understanding each woman’s story from an existential point of view to find personal meaning in their experience of motherhood has been highlighted by Donaghy [26]. For example, incorporating a baby who has died into the family story is a healthy form of adaptation and allows for the development of new relationships [27].

Women are also affected by societal views and expectations of motherhood. A generalized societal “myth of motherhood” exists, “fired by media and popular images of the attractive, perfectly dressed and made-up mother, with her happy, smiling family, an ideal which, if believed, serves to make women feel inadequate” [10], and may further be understood as needing to appear as “serene madonnas” or “capable super-mums” [10]. A strong and dominant myth endures in our society depicting women as “natural mothers, immediately able to care for their babies, and ultimately fulfilled in this role of selfless carer and nurturer” [28]. It is clear that the wide range of such ideologies and societal expectations around motherhood myths needs to be challenged, in order to support women in their individual transition to motherhood [28]. In fact, the ideal of the “good” mother which cannot be met may lead to inner conflict and can be associated with anxiety and depression [29]. Inner stressors encompass a fundamental change in identity [28, 30]. The subjective experience of first-time motherhood can be described under themes of (1) the realization of new motherhood, and (2) coping with new motherhood [28], which include attending to the demands of the baby and adjustment to motherhood. Changes in personal consumption in terms of eating, drinking and grooming are influenced by perceived risks to the baby [31]. Conflict arises when the material reality does not meet the expectations of the myth of new motherhood, in turn leading to negative experiences; hidden feelings of failure and undiagnosed depression and social support may be lacking [32, 33]. In this context, healthcare providers need to sensitively provide ongoing support to the mother whilst the ideology of motherhood is challenged [28] and meaning-making and spirituality are explored in relation to this pivotal and paradoxical life event [34, 35].

1.2 Jungian archetypes and use of fairy tales

Cultural myths emerge as artifacts of society in form such as stories handed down from generation to generation, often then being converted into dramatic and artistic multimedia artforms such as plays, movies, ballet, music, and film. These stories may include many elements which can be interpreted metaphorically. The universality of fairy tales in crossing cultural boundaries and addressing social and generational issues within the context of child and adolescent psychiatry is noted by Wallace and colleagues [36]. From a psychological point of view, fairy tales provide “grist for the mill” in human experiences, and have fascinated writers and practitioners in the therapeutic fields such as C.G. Jung. Myths and attitudes about mothers and motherhood are pervasive and foundational across all societies, and Jung describes the archetype of the mother within an array of archetypes [37, 38, 39]. An archetype may simply be described as a universal pattern in the psyche, in a similar manner to instincts [37]. Archetypes comprise key elements often in heightened imaginal form, providing the ingredients to understand human attitudes and behaviors which in turn assist the person with changes experienced in everyday life. Such archetypal patterns typically follow a distinct goal, “the meaning of which becomes more and more clear as they unfold in their actual expressions or images” [40]. Broadly from a Jungian stance, myths are seen as both particular and universal, needing translation into the language of the audience [41]. Archetypes typically address personal complexes linked to relationship issues, thereby enlarging awareness and empowering the living of an authentic life [20].

Archetypes are important in therapy, potentially echoing themes in the life experience of a person and bringing to consciousness what was previously unconscious or preconscious, in turn leading to transformation. Beebe lists a wide range of archetypal complexes which serve as patterns for internal dialogs within the self, including the hero, good father, trickster, divine child, good mother, and bad witch [42]. This internal process of development and transformation, terms individuation by Jung, is seen as a naturally occurring process within the human psyche where archetypal complexes are typically explored and ultimately resolved [20, 37, 40]. Therefore, the purpose of an archetype is to bring materials to consciousness and in doing so enlarge experience and make meaning for the person, contributing to the overall process of psychological growth and development. Clearly, issues from the primary family and their own experiences of being mothered affect progress toward individuation for any person. Additionally, significant issues occur for “replacement children” (after the loss of another child) as they grow and develop during adulthood, in turn affect their own attachment, identity, grief, and guilt [21].

The archetypal information carried by images can be worked with during progress toward individuation. Such images are found in the form of dreams and active imaginal reflections, which may be broken down into smaller mythologems as fragments within archetypal systems including fairy tales and mythological stories [43]. For example, a common and pervasive myth/archetype in today’s society is that of the hero. The hero’s journey has been particularly researched by Joseph Campbell and popularized in his talks with Bill Moyers. The hero’s Journey is present in many myths and stories around the world, across all cultures [44]. It is fundamentally about meeting and facing difficulties, developing through them, and coming to new understandings to bring back to everyday life. Used again and again in stories, books, and movies, the hero’s journey represents our human journey in mythological and archetypal form [45, 46, 47]. Mitchell notes that the mythological and fairy tale literature contains more heroes than heroines, and that heroines (female heroes) are much easier to find in fairy tales than in myths [48].

The archetype of the mother often occurs in an imaginal form in fairy tales as one type of archetypal myth [49, 50]. In fact, the study and interpretation of archetypes within fairy tales was largely initiated by Carl Jung [51], and has been continued by subsequent writers and practitioners [40, 52, 53]. Broadly, fairy tales have been used as a framework for “deepening the conversation about our clinical interactions and the meaning-making process in therapy” [36] and function as a continually recreated narrative [54]. More specifically, from a Jungian perspective, the analysis of the fairy tale leads to “the isolation, identification, and study of archetypal patterns and to the process of individuation played out as a whole endowed with meaning” [40]. Within the therapeutic process, clients may demonstrate or refer to the fairy tales explicitly or implicitly and may express personal associations and variations to each element of the fairy tales.

1.3 Interpretation of archetypal material

Interpretation of archetypal material assists the client in deepening the understanding of patterns within the breadth of human experience, and emergent archetypal patterns in working with clients have “a ring of universality, inherent order, or transcendence” [43]. Archetypal patterns may occur in fragmented form, and the basic core elements of mythologems (or themes) can form part of larger mythic narratives as the building blocks of the underpinning structures, as seen in fairy tales and other myths [37, 43], relating to emotionally charged ideas or images within a complex. The actual interpretation of archetypal client material is shaped by language in the form of the words used by clients to express themselves with both intentionality and action [55]. Similarly, Bettelheim sees fairytales as a more gentle way of approaching maturation and psychological growth compared to myths [41], and “cultural symbols” are seen as intermediate between personal and universal symbols [56].

Fairy tales typically begin with a deficiency, lack, or crisis and lead into the disequilibrium of leaving a calm known world into a dangerous and unknown world, reflecting conscious, preconscious, and unconscious material [57]. In reporting an image, the client may express their uncertainty about an image, where even just mentioning the words suggests that the idea/image is present and emerging into consciousness. Images and characters in imagery can carry latent and manifest meanings influencing not only the naming of fairy tale characters but also the characteristics of their actual behavior. This also links to the physical marker model theory [58, 59]. Ambivalence and contradictory feelings may be expressed and interpreted through mythical images [53].

The ubiquitous nature of fairy tales and the ways that fairy tales are adapted and re-told give further information about personal and societal viewpoints [60] linked to “the social mind” [57]. In fact, a proverb attributed to Italian/Greek culture states that “The fairy tale has no landlord”, thereby encapsulating the pervasive nature of fairy tales in society [60, 61, 62].

Attempts have been made to apply processes to fairy tale analysis [63, 64]. Applying a Jungian approach to dream interpretation to applying a Jungian approach to dream interpretation to fairy tales itself in terms of the main elements of the drama including time and place, the characters, and the storyline. Conflicts may occur as the narrative develops, generally leading toward resolution [63]. Following this, motifs or mythologems are amplified by exploring sign-based meanings within cultural expressions (literature and arts) framed within intertextuality [46]. Once the motif/mythologem is further understood, the next step situates this within its surrounding [63] in line with insights into the client’s context provided by variations from the expressed fairy tale. Finally, the preceding steps are synthesized and translated into an understanding of the psychological processes involved, typically focusing on the person’s growth and development as an integrative process [63, 64].

1.4 The tale of Snow White

Within the language and literature of fairy tales, the fairy tale known in English as Snow White was originally published as Schneewittchen by the Brothers Grimm as part of a documentation of current German fairy tales in 1857 [65, 66]. Multiple narratives, re-tellings, and variations on the Snow White fairy tale exist, including a range of interpretations and emphases [54, 67, 68, 69, 70, 71, 72], and this tale is in fact found all over the world [73, 74]. For those who may not be familiar with this fairy tale, a detailed outline by Robinson [75] is found in Appendix 1. Dillingham [63] summarizes this fairy tale as follows:

The Grimms’s [66] “Snow White” tells the tale of a princess born to a beautiful, self-centered queen. The queen has a magic mirror that confirms her supremacy as the most beautiful in the land until her daughter reaches the age of 7 and usurps her... Furious, she casts Snow White out into the woods to be killed, but the child is released and finds shelter in the home of the seven dwarfs... After years of domestic service in exchange for room and board, Snow White finally falls prey to the deceitful witch who puts Snow White into a deathlike state... A prince happens upon the dwarfs’ cottage with the beautiful Snow White in the glass coffin. He falls deeply in love with her and brings her back to his castle, where she awakens by chance, and the happy couple wed” [63].

Barzilai summarizes this fairy tale even further as: “a young girl flees from the murderous intentions of her wicked stepmother, finds shelter with the seven dwarfs, undergoes three trials or temptations, succumbs to the poison apple, and is rescued from her death-sleep by a charming prince” [54]. Johnston has identified eight key elements within this fairy tale: (1) Snow White the character, (2) the Evil Queen, (3) the Mirror, (4) the Huntsman, (5) the Seven Dwarfs, (6) the Apple, (7) the Revival, and (8) Happily Ever After [68]. Many aspects of this fairy tale have been explored deeply to understand how the elements carry information about societal expectations and appropriate behavioral models [65]. The tale of Snow White especially carries cultural expectations of marriage and domestication and focuses on family dynamics and transformation into womanhood as a source of jealousy and competition by the stepmother/queen [65]. In the final resolution, the prince is seen as essential, leading Snow White to her destiny of wife and motherhood [65]. This story carries themes of feminism, parental loss, and resilience [36], impacting issues of motherhood. Further, this fairy tale focuses on the “alterations that occur within a woman as a result of her own experiences in the maternal role” [54], and the “journey of a maid embracing motherhood” [73]. In particular, Perez [76] highlights the change in Snow White from being a princess to keeping house for the dwarves, where she “fulfills the role of the working woman who is responsible for the tasks of reproductive life” [76]. Others have engaged a feminist lens in approaching fairy tales such as Snow White [60, 70], including links to experiences of trauma [63] and gender ideology [60].

1.4.1 Key Elements

Looking more closely at Johnston’s eight key elements, and viewing this fairy tale within a clinical interpretive context, writers have focused both on Snow White herself and beyond the significance of the various elements of the story such as the role of the dwarves, the mirror, and the queen. Each of these eight elements will now be individually addressed.

Snow White is depicted as a beautiful princess whose mother died when she was very young; due to her father’s remarriage, she was raised by her stepmother. In addition to her beauty, Snow White demonstrates qualities of naivety, gullibility, and submissive maidenhood [68, 70]. Her apparently immature qualities are combined with industriousness in caring for others and she demonstrates an ability to survive against the odds when left in the forest. Her beauty inspires jealousy from the queen, mercy from the huntsman, kindness from the dwarves, and love from the Prince [68].

The Evil Queen, also known as the stepmother or the wicked witch [69, 77], is part of the mother archetype [78]. The Evil Queen is depicted as being vain in her need to be the most beautiful person in the kingdom, and she is intensely jealous of Snow White’s beauty [68, 70]. She relies on a magical looking glass also known as a mirror, to regularly determine who is the most beautiful person in line with her narcissistic behavior [70]. Bettelheim [52] comments on the narcissistic nature of the stepmother in the original story, and states that “It is the narcissistic parent who feels most threatened by his child’s growing up, because that means the parent must be aging,” with Schectman corroborating this understanding [79]. The dark and destructive nature of the Evil Queen is seen in ordering the death of Snow White and having her heart cut out as a trophy, which in some versions she also consumes. She sees Snow White as a continued competition and threat to her own survival and engages in manipulative behavior to destroy her via trickery and poison.

The Mirror, also known as a looking-glass, is seen as a magical device calibrating absolute beauty in response to the queen’s regular and classic question, “Mirror, mirror on the wall, who is the fairest of us all?” [68, 71]. The mirror is central to understanding developing consciousness, and a healthy sense of self [77]. The Mirror can also be seen as reflecting the effects of aging on loss of beauty and reframing of self-image [80], and therefore inherently draws parallels between youth and aging. The reflective nature of the mirror links to image, self-image, and critical self-reflective practices.

The Huntsman, also known as the woodcutter or even a servant, is directed by the Evil Queen to kill Snow White and bring back her heart. However, he responds to Snow White’s entreaty to be set free in the woods and not killed, resulting in leaving her alone and without any allies [68]. In doing so, he defies the order of the Queen and deceives her with a heart taken from an animal, despite the potential impact on himself. He exercises a benevolent influence on the unfolding story of Snow White, counteracting the destructive tendencies of the Queen.

Snow White arrives at the cottage of the Seven Dwarves, whose presence is a particular characteristic of the Snow White fairy tale. She engages diligently in cooking, cleaning, and household duties for the dwarves, reinforcing gender roles to stay home and take care of children [70]. The Dwarves also take on the role of surrogate family [68] and “have the character of Snow White’s sons” [70]; for example, in ensuring that they are washed, clean, and well-fed. Johnston also comments that the story would not be the same if it was “seven large men rather than dwarfs” [68] and here the influence of “little people” is evident. Across many genres, diminutive creatures often carry magical and other characteristics, such as elves, leprechauns, and little people of English, Scottish, Welsh, and Irish traditions [81]. From a Jungian point of view, dwarves may be seen as “guardians of the threshold of the unconscious” [82]. At the same time, the multiplicity of the dwarves may also symbolize internal fragmentation as the opposite of inner integration, in line with Jungian thought [82].

The Apple in this fairy tale aligns with Christian themes from the garden of Eden, where it symbolizes sin and temptation, within the context of frequent warnings by the dwarves that Snow White should beware of strangers [68]. The poisoned nature of the apple as provided by the disguised Evil Queen continues the sense of dark and destructive forces, causing Snow White to fall into a deep sleep which may indicate an end of innocence [70]. Sleeping also indicates a deep unconscious level of activity and the potential for transformation [82]. After she falls into a deep sleep, the Dwarves make a glass coffin to house Snow White and constantly watch over her [70, 74].

Being awoken from a deep sleep constitutes the Revival of Snow White and a wide range of versions exist about how this occurs, most typically relating to the moving of the glass coffin and a kiss from the Prince who has found her. The Prince immediately falls in love at first sight [68], which can also be seen as a sign of increasing integration and maturity within the psyche [70].

Following Revival, Snow White finds her Happily Ever After as a victory over death in marrying the Prince with a splendid gala wedding celebration [68, 74]. Symbolically, marriage may represent inner reconciliation and integration within the psyche as part of the individuation process [82]. Within the marriage celebration, dancing is seen as an incarnation of internal energy as change and movement occur over time as a uniting and integrating function [82]. The destructive influence of the Evil Queen is destroyed forever and a positive future is anticipated for Snow White [70].

The Snow White fairy tale is essentially about change, as are other heroic myths. Opperman makes a connection between naming the Queen as also a Wicked Witch in the Snow White fairy tale [69]. Further, he outlines how a critical incident or sensitizing event can lead to subconscious conclusions and reactions which remain latent until triggered later in life by an event or events, forming a pattern of responses; the task is to “wake up” from this pattern to become more conscious and able to live life to the full. [69] Patterns of interaction in fairy tales such as Snow White may be interpreted as part of an individual’s psyche, and offer insights into the psyche’s pathway to maturity [73]. The story of Snow White is seen as being about the development of the feminine psyche [73]. Hockley and Fadina consider that Snow White “embraces both otherness and difference, and in so doing she follows her own path through life” [67], toward living her life in an authentic and personally meaningful manner as conceptualized within the Jungian individuation process [67]. We now look at the role of Guided Imagery and Music (GIM) as a clinical modality supporting inner psychodynamic change via the use of spontaneous imagery with music.

1.5 Exploring the Bonny Method of Guided Imagery and Music

There are many ways that personal and individualized archetypal imagery can be evoked, and one therapeutic modality is the Bonny Method of GIM [83]. This current chapter uses the modality of the Bonny Method of Guided Imagery and Music (GIM) as the vehicle for bringing out experiences of motherhood, via a unique case with a clinical series, which will be further explained in the method section of the paper. In conjunction with the temporal nature of music, the GIM method creates a narrative of inner processes, rather like the clients creating their own inner movie, where the music forms the soundtrack. As an active and interactive music psychotherapeutic method with insight-oriented reconstructive goals [84], GIM therefore provides an opportunity for exploring issues of motherhood. Inner change can be depicted using the imagery process of GIM, and it is common for imagery including fairy tales to emerge, which can be very useful in understanding what is going on for the person, in an emergent manner [85]. Within the clinical method, session transcripts are produced within the normal documentation processes of the GIM session and a range of art-based modalities can be used to process emergent materials after the imagery experience [78, 86].

This GIM therapeutic approach specifically takes people into the imaginal realm and uses carefully selected music and specific “guiding” techniques to sustain and support an unfolding of the client’s imagery process. During this process, clients are encouraged and supported to produce active and ongoing imagery in the context of carefully chosen music, rather like a waking dream, and then this material is worked within the moment using non-directive interaction occurring between the client and the therapist, which may include a wide range of supportive verbal and vocal interventions [46, 58, 87].

GIM is often practiced from a Jungian therapeutic stance [88]. It is known from clinical experience that archetypal material, in the form of fairy tales and myths, may occur within the GIM process [89, 90], but there is still a great need for more to be formally written and researched in this area. From anecdotal sources and personal experience, it seems that the manner in which the story unfolds for the client may be somewhat varied, with a tale or myth occurring in one session or over a longer series, and not necessarily in a linear narrative sequence. Clinical experience suggests that it is rare to find a whole story or archetype unfold in detail within a single clinical GIM session, and fragmented archetypal material may be produced within and across a series of GIM sessions. The client may alter the basic tale or myth at various points, in a way that is relevant to their circumstances and modes of operation. The way that clients may change various aspects of an archetypal story gives additional meaning and provides further understanding within the clinical setting. Viewing archetypal material from a Jungian stance assists the client in that the GIM therapist can encourage the client toward the next major step in the story and perhaps have some idea of how change may be achieved. For example, in order to return home when the tale is “The Wizard of Oz”, clicking feet together may well be the solution, and thus the GIM therapist may gently suggest the client looks down or considers if they are wearing footwear. Thus, both client and therapist benefit from a knowledge and understanding of archetypes as they occur in the GIM process.

Combining an understanding of the inherent changes of motherhood with archetypal understandings around the role of fairy tales within the context of GIM practice, the specific questions that this research case study focuses on are:

• How can issues of motherhood be identified and understood using imagery processes, within the GIM music psychotherapy context

• How can such imagery be understood and interpreted in the light of Jungian archetypes and fairy tales

• Can new theoretical and methodological understandings arise from the reframing of a previous case report into a research case study to provide a deeper understanding of previous client data from a case report

• How can we further and more deeply understand the psychological work engendered by matresence and the change to motherhood?

2. Method

Qualitative research approaches lend themselves well to applied clinical practice in the therapeutic field since they foreground an interpretation of the words and experiences which are expressed by the client. This can be captured in written form in many ways. Clinical case reports typically take an informal qualitative approach as a recount of the clinical session with therapist reflections which are important for developing understandings and communicating with further clinicians [91] and in the context of education [92]. However, contemporary understandings of the research case study take a more systematic approach to methodology in the clinical context. Alpi and Evans explore the differences between a case report and a research case study, where the latter is important in addressing the complexity of deep and rich data within a real-world context [93]. Case study research contributes new ways of understanding complex practices, linking conceptual understandings derived from research to applied research-based practice as a snapshot in time and space to provide new understandings [94]. The essential role of both clinical research and formal evidence-based research is considered by Szajewska as needed to contribute to improved health outcomes for clients [95]. Systematic case study research contributes valuable evidence which can describe, explore or explain a clinical phenomenon of interest within a particular context, and which can document and theorize rare events in the naturally occurring context, which in turn builds professional knowledge in a credible manner [96]. It is noted that concurrent typologies conceptualizing research case study from Stake [97] and Yin [92, 98] can be applied within the research process [96].

Following early publication of specific case report [1], further approaches exploring clinical cases from a research point of view have been explored and developed to shed light, informed by thinking about how a research case study approach can be applied to GIM practice [99]. By updating and integrating both theory and methodology, the current article aims to achieve deeper understandings of the previous clinical case report by further contextualizing and expanding the clinical information into a research case study, using additional evidence and a deeper reflective and analytical process in line with current research understandings. In doing so, this article demonstrates a complex approach of seeking to change one type of publication to another, updating theory and method to achieve deeper understandings relevant to practice. Whilst the original case report detailed many clinical aspects and some reflective and interpretive processes based on the literature and experience available at the time, a more thorough and systematic research case study approach was anticipated to have value in deepening understandings of this unique clinical case material.

In fact, research case study methodology allows for the intensive description, exploration, and explanation of a particular case or group of cases, and can provide valuable knowledge which communicates effectively to clinicians seeking to apply new knowledge to their practice. Research cases may be selected in a number of different ways, using the context to explore what is described as an intrinsic case with unique characteristics [96, 97]. Further, an explanatory approach [92, 98] can be applied to illuminate the case in its context. A clear and systematic methodology needs to be established for case study research, especially considering multiple data sources and the way that these are analyzed. These analytic techniques include (1) pattern matching, related to observed and predicted patterns, and (2) explanation building, using an iterative process to understand the complexity of the pattern matching as based on the work of Yin [92] in order to understand all of the research and clinical implications.

2.1 Systematic approach

Combining these several different theoretical and methodological requirements, the systematic method devised for the current research case study application comprises the following steps: (1) identify an intrinsic case with unique characteristics; (2) identify a pattern evidenced in the clinical material; (3) apply analytical techniques of pattern matching, and (4) undertake an iterative explanatory approach to understand the complexity of the pattern matching and its variations. Within this, a Jungian interpretive framework informs the overall methodology, as has previously occurred in other work undertaking an intertextual semiotic approach [46]. The current four-step methodological approach is now further explained.

2.1.1 Step 1. Identify an intrinsic case with unique characteristics

This first step involves identifying and choosing a suitable case. In this instance it focuses on the Snow White fairy tale in clinical practice, stemming from a previously published case. The unique characteristics of this case are outlined according to known clinical details related to the participant, the application of the GIM therapeutic modality, published details, and further reflections by the GIM therapist. The intrinsic value of this case relates to the rarity of an entire fairy tale occurring spontaneously in a single GIM or other Jungian-oriented clinical session.

2.1.2 Step 2. Identify a pattern evidenced in the clinical material

Patterns serve as models or designs which provide predictability via a repeated or regular way that something is done which can serve as a useful guide for further work and delineates how things are usually done. In terms of behaviors, a pattern may be informative about personality or approach, and patterns in data can inform analysis within the context of research. A fairy tale is a cultural model or design which has emerged as a patterned cultural artifact. The current methodology utilizes a systematic approach to reviewing the Snow White fairy tale, expanding from ad hoc clinical insights noted in the previous publication [1]. By revisiting current literature to inform the analysis process, an increasingly systematic approach to elements of the fairy tale is provided, specifically the eight elements outlined by Johnston [68].

2.1.3 Step 3. Apply analytical techniques of pattern matching

The pattern from Step 2 then informs the analysis process by providing a sound basis from the literature and further supports a systematic examination of the client’s depiction of a traditional fairy tale and any deviations they may incorporate into their personal fairy tale. Although this was already previously attempted somewhat [1], a more detailed, comprehensive, and systematic approach now occurs at this step in the current research case study.

2.1.4 Step 4. Explanatory approach to understanding the complexity of the pattern matching and its variations

Following the results of pattern matching in Step 3, an iterative review and interpretation process takes place in order to explain meanings and implications related to the client’s depiction of the Snow White narrative in terms of both motherhood and psychodynamic change related to a Jungian interpretive framework.

2.2 Data sources

A range of data sources informs this research case study. Clinical data sources include regular field notes of a full written transcript which is documented within normal GIM session practice, with associated clinical notes and observations. Additional participant discussions within the session, both before and after the music and imagery experience, are also included, as are materials from previous GIM sessions [100] within an interpretive approach based on intertextuality [46].

3. Results

Results of this research case study are now unpacked in terms of the carefully developed systematic approach used for in-depth exploration of this intrinsic case based on participant materials generated within a single GIM treatment session.

3.1 Step 1: An intrinsic case with unique characteristics

Rarely, an entire fairy tale is spontaneously reported and outlined within a single GIM or other Jungian oriented clinical session. Therefore, this selected case demonstrates intrinsic value in depicting an entire fairy tale in a single session, at the same time demonstrating unique characteristics in the way that the client uses and adapts the emergent Snow White fairytale to fit her needs, thereby providing further information about her current experience related to matrescence and the change to motherhood.

Clinical details about this case are as follows. This client had previously undergone an eight-session series of GIM during pregnancy. At this time, her therapeutic process focused on issues related to adaptation to pregnancy in terms of her body, her relationship with her husband, the resolution of prior ectopic pregnancy, and bonding with the male fetus baby in utero [100]. This client now had a new (female) baby who was five months old, her last GIM sessions having taken place approximately six months previously. During this break, she had undertaken no other therapy-oriented session.

Since there had been a long break since her previous GIM sessions, and since there had been such tumultuous changes in her life and lifestyle in the intervening period in view of motherhood, this current session was viewed by the therapist as being novel in terms of a new beginning, expecting that the client would now be at a different point in her therapeutic process after the birth of her child. She reported that her baby had been a somewhat demanding child, that she was still breastfeeding her, and that she herself was feeling tired.

This current GIM session proceeded according to standard processes and applications [58, 101]. Following initial therapeutic discussion, routine decision-making took place with regard to the specific music program to be used. In this case, the music used was the program entitled “Relationships” [102, 103, 104]. The “Relationships” program comprises music of three different composers and is designed to promote inner interactions within the imagery process. For example, this GIM program begins with the Concertstuck for Harp, by Pierne which has flowing melodic lines, broad tessitura, and varied instrumentation which includes substantial use of stringed instruments. It carries a sense of predictability, despite a full range of dynamics and a significant climax. Instruments are used in opposing groups, with a sense of “asking and answering questions.” This GIM program allows for many possibilities to emerge and for the client to relate to them using their imagery processes, in line with Bonny’s multilayered principles in the use of music for GIM [103]. This program was extended by adding music to complete the client’s imagery experience, which was the “Pavane” by Faure, known to be a suitable music style that could be added to the relationships program. The full listing of all the music appears in Table 1.

Music	Length (Minutes: Seconds)
“Relationships” (Helen Bonny)
Pierne, Concertstuck for harp and orchestra	14.48
Rachmaninov, Symphony No.2, Adagio	14.11
Respighi, Fountains of Rome: Villa Giulia at Dawn, Villa Medici at Sunset	9.02
Additional music, from “Creativity 2” (Linda Keiser Mardis)
Faure, Pavane	6.04

Table 1.

Music used in GIM session [104, 105].

3.2 Step 2. An identified pattern from clinical material

After a few transitional images to begin the imagery process, the client immediately reported a confronting spontaneous image of a witch, a typically fairy tale figure, and later little dwarves/elves. In fact, most of the elements of the Snow White tale began to emerge within her reported imagery of her GIM session. As is often the case in image-based material, the client used words interchangeably, such as witch and stepmother. Post session reflective practice brought to light the full extent of this unfolding of the fairy tale, with similarities and differences to the traditional tale providing interesting and informative clinical information. The identified pattern of the fairy tale in this session was noted to hold intrinsic value and unique characteristics. This unique session was subsequently written up into a clinical case report based on knowledge and experience at the time and published following peer review. Interest in this case report has continued over time, as noted by citations and research impact metrics.

Extending insights from the clinical case report [1], the current paper applies a systematic framework informed by current literature to delve further into the cultural artifact of this fairy story. Johnston’s eight key elements of the Snow White fairy tale are chosen as the pattern against which to review the client’s fairy tale material [68]. These eight key elements are: (1) Snow White the character, (2) the Evil Queen, (3) the Mirror, (4) the Huntsman, (5) the Seven Dwarfs, (6) the Apple, (7) the Revival, and (8) Happily Ever After [68]. All of these elements were found to occur in this GIM session and this pattern thereby sheds light on the clinical material of this client’s reported imagery.

3.3 Step 3. Pattern matching in the context of client data

Employing a systematic and comprehensive approach, a methodological step was needed to identify changes and amendments to the traditional Snow White fairy tale. In order to do so, the client’s narrative text from the session transcript was broken into meaning units throughout the entire transcript via an iterative process. This was then compared to the pattern of the generic Snow White fairy tale [68] as has already been identified in Step 2 within the current methodological framework. The client’s narrative fell naturally into 15 parts. These include the eight elements of the fairy tale, some with a Reprise, and some additional variations called Caveats in this current chapter (see Table 2).

#	Element	Caveat	Text from client
E-1a	Snow White		The narrative is coming from the point of view of Snow White, she is the character, and therefore is assumed at the beginning of the client narrative.
E-2	The Evil Queen		I am seeing a ridiculous woman from fairy tales, with the same face as the wicked witch. Not evil, different clothes, purple. She’s looking me over. Not a princess, not a witch. [Does she have something to say to you?].
E-3	The Mirror		She’s looking me over, to see if I’m a good mother or not. She’s not sure - I’m not really interested. [Is there something you would like to say to her?] “Mind your own business”. She snickered and walked away, I turned my back.
C-1		Castle and Babies	A castle, like fairyland. Blue/turquoise surrounds a grayish castle, it is up really high. There are baby heads in all the castle windows. I feel like I have to go up and take care of all the babies, millions of heads. I cannot take care of them all.
E-4a	The Huntsman		Not present at this point, see later.
E-5a	The Seven Dwarves		Off to the left. I dance with mid-height fairy creatures, 4 feet high. They are dancing in a circle around me, going off to the left. I dance with mid-height fairy creatures, 4 feet clockwise, I am turning in the other direction, They are all holding hands—more and more of them, getting to be a bigger circle. It is harder to see I liked it better when there were just a couple and they were close. [Can you ask them to go away?] Yes, I will do that.
E-1b	Reprise: Snow White		Watching someone else dance, a woman. She is all alone, it is beautiful to watch her dance. A lot of jumping and turning. She does not have any children to worry about, or would not be doing it that way, single childless woman. At first, I am envious, but now I realize that if she stops dancing, she will realize how alone she is. She stopped dancing [music likewise] and is walking away.
E-5b	Reprise: the Seven Dwarves		The little elves are back, they were green before, but now they are all different colors. They are all asexual, just little elves. I wish I could replace them with kids, they are all the same.
C-2		The Boy	[a deep sigh] A motorized car, with a sidecar, with a little boy in red overalls, like a red pedal car. I am not having to pedal. He is on my right, a blonde boy with bangs. He thinks it is just great, going without pushing. It is going so fast and very smooth. The landscape is rolling peacefully and quickly by. I feel like I want to slow it down. I slowed it down [the music actually slowed down too].
E-6a	The Apple: Poison food Part 1		The boy is still on the right, but on the left, a sensation of sweet food. Cakes, lollipops, icings, and colorful bright pastel decorations on cakes. No chocolate [said longingly]. [Can you find some chocolate?] There is a chocolate bar 4 ft. high, and a man saying “forget it,” I cannot have it because of nursing. [Would you like to take a tiny taste?] I can have a taste if someone else feeds my daughter. I’m eating a lot of it, and giving the little boy some. It’s all over his face, and my face.
E-6b	The Apple: Poison food Part 2		We are getting back into the car, with the scenery going by. There is something drawing me to the right. Clouds, not terra firma anymore. I am going upwards, flying upwards, and floating down on one of the balloons [from recent balloon festival]—a balloon parachute. Colored fabric, silky, primary colors, red, yellow, royal blue, green, orange. Deep and bright, rich and satiny, soft, flowing. Rolling up in satiny fabric. Colors so bright—happy colors. I am inside of the material floating around, just my head is uncovered. Like a cocoon, not tight, flowing, gently changing. Not able to see anything anymore. Dark, deep, deep purple, and green spiral, going around clockwise. I am going around the spiral from the top.
E-7	Revival		Something is stopping me from flying off to the left. I am jerked back by a force. I am tempted to let go, but still holding on, not spinning as fast, much slower, like a broken record I am going to get off. I’m stepping off, down some stairs. There are a lot of people, adults I do not recognize. There are different layers of people, different levels of people. There is white light as I go down, it is not getting darker. People are going past, looking grumpy. [Is there something you would like to ask them?] I do not feel like I know them well enough. They are not sad or angry, just grumpy.
E-4b	The Huntsman		I’m focusing on one of the people, with a beard and a mustache. He does not look like a real person. His hair just went from reddish brown to white and old. He does not look as grumpy. He went outside and back up, [Does he have something to show you?] It seems so. He is taking me back to where I was. I linked elbows with him, I am running circles around him. He says I should slow down and let him guide the way.
C-3		Baby Daughter	I am in a place with all these animals, foxes, raccoons. [Daughter’s name] is playing with all the animals. It’s very safe, she does not realize they are wild animals - they are safe. She’s got a lot of hair, like a year old or 18 months. I do not want to startle her - if she sees I’m here, she might be bitten. She went from being a kid to a teenager with a wreath on her head. She is walking toward a castle church. She hears a noise.
E-8	Happily Ever After.		I lost that image. There is a man and a woman, dancing, and moving together. They are doing the same movements, next to each other. One is a shadow of the other, like ice dancing. It is getting lighter, like a sunrise. I cannot see the sun. I feel like watching the dancers. They are walking. Distinct, parallel steps. [end of music] They walk away into the horizon.

Table 2.

Pattern matching of client data to Johnston’s eight elements.

Note: Italics are used for explanatory comments; italics in brackets are used for the therapist’s verbal interventions where they have significantly impacted the client’s process.

3.4 Step 4. Explanatory approach to interpreting the complexity of patterns and variations

Various observations and interpretations can be made about how the client used the Snow White fairy tale to convey information about their current life experiences of motherhood. Within the client’s imagery narrative, Snow White as a beautiful woman dancing alone has a sense of being able to move freely at her own choice (E-1b). She has no children to worry about and the client is envious of being “single and childless.” But then a subsequent realization of aloneness is expressed and the woman walks away, leaving this experience behind. This imagery accesses the challenges of matrescence in changing to incorporate the child into the life of the mother, and acknowledges the desire to return to individual freedom and agency in life prior to motherhood, and the “worry” of children is explicitly addressed. However, this imagery also carries reflection and comparison about aloneness, suggesting the benefits of family, belonging, and the larger picture of motherhood as an integral role in society.

The apparent conflation of a wicked witch with the Evil Queen (E-2) in the standard fairy tale suggests an ambivalence about female characters and energies. The word “ridiculous” suggests that there is something out of joint in the situation, and yet the color purple suggests royalty which links to the original tale. This ambivalence suggests that the client has further work to do around the role of her female energy and her sense of self as she grows into matrescence.

The sense of inner comparison appears in being looked over “to see if I am a good mother or not” (E-3), and this embodies a strong sense of reflection as in the Mirror in the original fairy tale. The Evil Queen expresses ambivalence about the outcome of this assessment of her mothering skills. However, the client shows inner strength in rebutting the older woman by saying “mind your own business” and turning her back on her. Therefore, the power of the older woman over the younger woman has broken as she snickers and walks away (E-3). This imagery sequence speaks to imposed expectations about mothering by older women and more broadly the cultural and community mores about mothering. This is directly in opposition to individual development of the mother’s skills in caring for their specific baby in relation to the current time, place, and context. Writers such as Winnicott have spoken about expectations of mothering where the concept of being a “good enough mother” to the specific child cuts through expectations of perfection [106]. The fact that this client can express disinterest and turn her back on this overt comparison suggests an inner resilience in her own development as a mother.

Immediately following this comparison/assessment of her mothering abilities, a Caveat appears focusing on a Castle and Babies (C-1). The babies become more and more multiplied in the gray castle with windows with many heads and more needs. The client expresses feeling overwhelmed by more needs than she can take care of, which may link to her everyday experience of the demands of mothering. The gray of the castle may also suggest a sense of depression, and the context of the castle being up high suggests a sense of unreachable, unattainable high standards in caring and motherhood.

The Dwarves in this fairy tale are variously described as “mid-height fairy creatures” and elves, and they are described as having an asexual nature (E-5a, E-5b). Engagement occurs through dancing with them, and they circle around her with a similar multiplicity to the many heads of babies in the previous Castle imagery sequence (C-1). Interestingly, they also take on a wide range of colors, perhaps suggesting the release of emotion and feeling tones. In contrast to the overwhelming multiplicity of baby needs, the client now wants to “replace them with kids” with the implication of greater individuality. Such children are clearly older than babies and may suggest a desire to move forward from the demands of early mothering. This also serves as an opening into the next section, about a little boy.

The little boy wearing red overalls and in a red motorized pedal car appears as a Caveat to the Snow White tale (C-2), and as such holds considerable significance. He is understood to likely be a further manifestation of grieving and resolving a previously lost ectopic pregnancy. This little boy previously wore red sneakers (shoes) in a previous sequence of 8 GIM sessions, where he appeared in sessions 2, 5, 7, and 8, the last session being some 6 months prior to the current session [100]. In the current session, the client sighs, suggesting a letting out of emotion as the little boy appears. The client notes smoothness and speed of movement without effort, within a peaceful ongoing journey which is also under her control for slowing down. Her sensitivity to the little boy’s emotions is indicated by “he thinks it is just great”, and her mothering relationship with the boy extends into the next section by sharing some chocolate with him within her journey.

The element of the Apple in the Snow White fairy tale appears for this client as symbolized by poisoned food that is harmful (E-6a, E-6b). Given that as a mother she is nursing/breastfeeding, she is acutely aware that foods and substances she ingests as affecting the growth and development of the baby. One such food is chocolate, where the inherent caffeine has the potential to affect the baby via the lactation process. The client images an extremely large chocolate bar (4 feet = 122 cm high) which is accompanied by a man forbidding her by saying “forget it” and her own reflection, “I cannot have it because of nursing.” However, she arrives at a solution—that she can eat it “if someone else feeds my daughter.” She then engages thoroughly with the chocolate, eating a lot, smearing it on her face, and likewise sharing it with her little boy.

As with the poisoned Apple in the original fairy tale, ingesting forbidden chocolate leads to an opening into a transformative state of consciousness (E-6b). This is indicated by feeling drawn away from the earth into the clouds; flying, flowing, and floating with bright colors with rich soft satiny materials. Her passive movement is followed by the sense of a cocoon, dark and not able to see, which echoes the coffin of the fairy tale but there is also a sense of inner growth in the purple and green upward spiraling movement.

Suddenly, the client experiences a slowing down and downward spiraling movement (E-7), being “jerked back by a force”, and actively steps onto a platform to go down some stairs as she awakens in the Revival to a new context of light with different “layers” and “levels” of people. She identifies a pervasive feeling of “grumpy” in the people, and this emotional tone suggests that more inner work is in process of emerging.

Through focusing on the many different people, a male emerges who could well be described as the Huntsman (E-4b), with a beard and mustache. He is less grumpy than the other people and transforms into a benevolent older man, which the client says significantly, “he is taking me back to where I was.” He encourages her to slow down, functioning as a guide figure for her (in line with the myth of the hero’s Journey) and re-orienting her to motherhood, as shown in the next section.

Once more, a Caveat appears in the Snow White fairy tale, this time the client’s baby daughter who is happily and safely playing with wild animals (C-3). In the imagery, she anticipates the growth and development of her baby into a child and teenager. Having a wreath on her head and walking toward the castle church suggests marriage and union, and here the imagery crosses over into the inner growth and development of the client. This section is punctuated by hearing “a noise” and the image changes completely.

The Happily Ever After section of the fairy tale (E-8) is depicted with a man and woman dancing in harmony together, ultimately walking into the emerging new light of the sunrise toward the horizon with a sense of happily ever after. It is interesting to reflect on the clear changes seen in the imagery from a single childless woman dancing alone to the man and woman dancing together as a seeming integration of opposites within the sense of family and motherhood. In this imagery, clear progress has been made from the single childless woman dancing alone and then eventually the man and woman dancing as an integration of opposites and also symbolic of the family.

In focusing on the role of the music within the client’s depiction of the fairy tale, as has been useful in other contexts [107], and assuming that music and/or rhythm is inherent to any mention of dancing, we note the effects of music and sounds of dancing with the dwarves, the childless woman dancing alone, her daughter hearing a noise which leads to a complete change of imagery, and the man and woman dancing closely together. In these instances, the music of dancing clearly embodies psychic movement which happens together with the imagery process itself.

4. Discussion

This paper reviews and re-works a previously published clinical case report [1] into a research case study as seen through the lens of an intrinsic case with unique characteristics, following an explanatory approach within a research case methodology, in line with the thinking of Wolf and colleagues [96]. This unique intrinsic case focuses on a client depicting the Snow White fairy tale in their spontaneously generated imagery through the progress of a single GIM session. Arising research questions are specifically addressed in relation to motherhood, the use and interpretation of imagery, new theoretical and methodological understandings, and an understanding of the contribution of the GIM method in assisting with matresence and the change to motherhood.

4.1 Motherhood, imagery, and society

Client materials emerging in this GIM session clearly focus particularly on issues of motherhood, building from the series of eight sessions prior to the birth of her baby daughter, who is now five months old at the time of this current GIM session. A previously explored “child” of an unsuccessful ectopic pregnancy also appears within the spontaneous imagery [100], leading to further integration.

Much of the existing literature about motherhood has been about the child being acted on by the mother. However, this chapter focuses on the extraordinary inner changes needed as a girl transitions to being a mother via the process of matresence. Many changes occur in the transition to motherhood, as a new identity and self-concept emerge within the mothering role [28, 30]. In line with this, the client expresses a number of issues about her change to motherhood through the imagery as individualized within this depiction of the Snow White fairy tale and its variations.

Self-perceptions of perfection and maintaining a sense of self connect closely to the issue of being a “good enough mother,” as brought out by the Mirror of the fairy tale, and this suggests a sense of comparison along the generations, also incorporating intergenerational issues relating to changes in mothering practices with each new generation. The role of the “good enough mother” has particularly been addressed by Winnicott [106], where the mother’s abilities are influenced by the social environment and emotional support available [108]. Further, Winnicott makes redundant the idea of the “perfect” mother [109], seeing this unrealistic ideal as being inferior to improving while doing and learning from failure toward implementing best practices [110].

Another aspect of the change to mothering brought out by the client through using the fairy tale is about the problems of mothers getting what they need, including food and nurturing as their roles and daily life change [2, 13, 31]. This occurs within the context of frequently needing to deny their own needs, as brought out by the client’s imagery of forbidden food which can harm the baby. It is noted that this client is able to solve this dilemma by finding someone else to feed her baby so that she can attend to her own needs, thereby demonstrating problem-solving adaptability to be able to take in her desired food.

Accessing and acknowledging so-called negative feelings is part of a psychological re-evaluation of values, beliefs, and self in the transition to motherhood [18]. Feelings are brought out by the many “grumpy” people that the client awakens to a new transformed context after the poisoned food, and this grumpiness may indicate a general dissatisfaction and weariness caused by the implicit expectation of being an on-call mother selflessly focusing only on her baby.

The client’s imagery also brings out a clear juxtaposition of identity about what it means to be single and then to become a family, as shown by the freedom but aloneness of the single childless woman and a recognition of her current envy of the single life but at the same time acceptance of belonging and family. This integration is even further underlined in the integration of opposites as the client’s depiction of the fairy tale ends with walking into the sunrise as a new beginning.

Linking both the literature and the client’s experience, it is clear that GIM can act as a method helping bring out and track issues of the inner changes in motherhood, which can then be interpreted from a Jungian stance as a user-friendly method assisting with adaptation to motherhood after childbirth.

4.2 Jungian approach to imagery and fairy tales

Using a music psychotherapy approach such as GIM to help bring out issues about motherhood, we can delve even deeper to derive understandings from a Jungian standpoint. As Ventre notes, GIM can serve an important role in addressing the archetype of the mother by facing the “dark side of the external and internal feminine forces in her life” [78], providing case material of transformation toward holistic acceptance and power within the individuation process. Fundamentally, the Snow White fairy tale is about change, as are many myths and fairy tales containing archetypal material, as seen in the way that the client represents their journey via this fairy tale. Along with the trials and changes met in everyday life, this tracks inner growth and development and is also closely linked to the Hero’s journey [46, 47]. Therefore, the client-hero needs to find new skills and coping strategies, both internally and externally in the real world, as they confront unfamiliar scenarios and high levels of anxiety as they occur [47].

In the transition to motherhood, heroic change is needed to meet the extensive needs of motherhood. This plays out for the current client in being catapulted into an unexpected journey especially shown by sensations of moving up and down, exploring the psyche as the client encounters trials and tribulations within the imagery process and relates them to motherhood. The dual image of the benevolent Woodcutter as a Guide within her heroic journey emerges within this current research case study as an insight not previously gained from the earlier case report [1].

4.3 Innovative research approach

In reframing this clinical report into a unique research case study, a systematic methodology has been developed involving a pattern-matching approach. In doing so, it provides increased insights forming evidence to inform clinical practice within a Jungian theoretical framework. This occurred by reviewing an intrinsic case with unique characteristics, as informed by the work of Stake, Wolf, and Yin [92, 96, 97]. Using this methodology, new understandings came to light, for example, connections between the role of the benevolent woodcutter re the guide figure. Merging a Jungian fairy tale approach interpretation [63, 64] with a systematic research methodology was sustainable in deriving new knowledge at a deeper level than had been attained in a previous case report [1].

This chapter has made a clear delineation between a clinical case report and a research case study, following on from the work of Alpi and Evans [93]. In doing so, the ad hoc nature of interpretation has been addressed within the application of well-delineated patterns (in this case the Snow White fairy tale [68]). Not only this, but in creating understanding of the nature and role of the clinical case report versus the research case study has been applied across the significant time gap between the publication of the initial case report and the current research case study. These improved understandings form a fresh contribution to methodology development, and the process outlined in this paper can be further applied to other fairy tales and archetypal stories as may appear in imagery within the clinical context.

4.4 Understanding the work of matrescence

In working our way through this intrinsic case with unique characteristics in the form of a research case study, we are faced with an even deeper and broader understanding of the inner work engendered by matrescence as the client changes to embrace motherhood within psychic development. Firstly, there is an inherent comparative aspect to mothering which occurs both intergenerationally and with peers. This has the potential to destructively affect the transition to motherhood. Within the imagery, this was experienced as both a looking over to see if she is a good mother and a sense of many people watching her as a mother.

The gaze of others links to community expectations of the role and behaviors of the mother [4, 6, 7, 10, 32] with broader societal issues seen as linking to feminism and gender ideology. In this context, poisonous destructive behavior may occur between women, and broad and diverse support needs to be offered to new mothers [29].

However, what is of fundamental importance is the mother’s relationship with the child, their partner, and inevitably with their own self in order to fully embrace a mothering role in a sustainable manner into the future of this long-term commitment. A close review of this GIM session has provided an opportunity for such foundational values to surface and be acknowledged within the psyche. Broader issues from the literature highlight that the maternal attributes engendered by the change to motherhood can lead to consequential role conflict as the new mother experiences multiple challenges and substantial inner change, where both achievements and losses influence the maternal role [13]. Various aspects of these challenges amidst ongoing change have been pointed to by the current client, such as the fragmented work of mothering with many tasks and seemingly many children to constantly look after.

Darvill and colleagues have noted the need for an appropriate support network prior to birth but connecting with other pregnant mothers [12], and this could be further extended to support women as they transition into their new role of motherhood and develop a sense of agency [32]. The fact that such deep psychic change was evidenced in a single GIM session speaks to the value and immediacy of the GIM music psychotherapy method as an option to consider and suggests that further value may be achieved in offering this method to new mothers who are both managing well or experiencing difficulties, as long as well-trained and experienced GIM practitioners are available to undertake this work (see MIAA, musicandimagery.org.au).

Limitations exist with regard to the research case study approach in terms of scope of a single client and the way that the current paper has sought to transform a previous case report into a more systemized research case study. Trustworthiness has been introduced by clearly articulating preconceived beliefs and assumptions such as emerging from a Jungian theoretical approach to interpretation. This current research case study is seen as problem-driven rather than methodology driven, and in applying this new methodology approach new understandings have been derived that link established literature to interpretation within a clinical self-report process.

Within a qualitative approach, generalizations cannot be made from this research case study but nevertheless the results assists with discovering and linking unexpected issues. The research case study approach forms a solid contribution to theory, research, and practice as noted by Wolf and colleagues [96].

5. Final comments

The transition to motherhood has a powerful effect on the psyche of the mother, fostering an awareness of opposites and integration of the personality leading toward individuation via the mother archetype. By using the vehicle of the Snow White fairy tale in this instance, the client has demonstrated a capacity to use and adapt myth and mythologems to serve the needs of her inner dynamic processes in relation to mothering. In doing so, it is proposed and confirmed that GIM can support and assist with this process and that the GIM therapist can use knowledge of archetypal material such as fairy tales to encourage and support clients in their transition to motherhood, leading to associated benefits for both the mother and their child.

Acknowledgments

Grateful thanks are offered to Anita Short for her ongoing advice and encouragement for this reconceptualizing and rewriting project, despite the unusual circumstances in which it was given. Consultation and experienced review by Dr. Anne Hogden are additionally appreciated.

The elements of this basic fairy tale of Snow White are summarized, see [75].

The Queen very much wants a beautiful daughter. This dearest wish comes true with the birth of Snow White. However, when the child is born the Queen dies. A year later, the King remarries a beautiful but vain woman, obsessed with the perfection of her beauty. As Snow White grows up into a lovely girl, her stepmother realizes that she is turning into a more attractive woman than she is herself. This makes her furious. She tries to get rid of Snow White, but the Huntsman/father delivered with the charge of killing Snow White takes pity on her and, disobeying his orders, releases her into the forest. Terrified, Snow White comes across a tiny, tidy house with seven of everything. Snow White falls asleep and greatly surprises the industrious Dwarves on their return from work. In return for domestic chores, the Dwarves offer Snow White protection. Snow White settles down quickly into the routine and becomes fond of the Dwarves and them of her. One day the feared event occurs. Dressed as an old pedlar woman, the stepmother arrives. Snow White, tricked by the wares of lace and ribbons, allows the old woman to lace up her bodice so tightly she cannot breathe and she faints. On their return, the Dwarves fear Snow White is dead but she is quickly revived by their administrations. Despite the Dwarves’ precautions, Snow White is duped again by the stepmother, this time by the enticement of a beautiful but poisoned comb. Although rendered unconscious again by the poison, Snow White survives. The Queen comes a third time with a poisoned Apple. Snow White is unable to resist the rosy shine, takes a bite, and dies. The Dwarves are disconsolate and are unable to bring themselves to bury Snow White out of sight. So they place her in a glass coffin on a hilltop. An owl, a raven, and a dove come and sing over the coffin. One day a Prince comes by. He is so enchanted by Snow White that he persuades the Dwarves by his sincerity to part with Snow White’s body. Whilst trying to move the coffin, the Prince’s men stumble and jolt the coffin, dislodging the Apple from Snow White’s mouth. Immediately, she awakes. The Prince and Snow White are married. The stepmother, unable to resist her curiosity, attends the wedding but is recognized and made to dance in red-hot iron shoes until she falls down dead.