INTERNATIONAL JOURNAL OF STRUCTURED ASSOCIATION TECHNIQUEAn Electronic Journal of Social Skill, Counseling and Imagery Therapy

NUMBER 2 − AUGUST 2008

CONTENTS

1. Study of Supportive Intervention for Stress Reduction and Perceived

Confidence of Child-Rearing Mothers …………………………………..
Kyoko Yajima and Sayuri Hashimoto

3-35

2. Examining Effects of Human Relation Skill Using Genetic Temperament
Concept on Stress Management: 3-month-followup Intervention…………………
Kyoko Tanaka and Tsunetsugu Munakata

36-62

3. Shift in Frequency of Voice Accompanied with Emotional Change ina Cancer Patient ………………………………………………………
Kei-Ichiro Kobayashi and Tsunetsugu Munakata

2

63-75

A Study of Supportive Intervention for Stress Reduction andPerceived Confidence of Child-Rearing Mothers

Kyoko Yajima and Sayuri Hashimoto

Department of Human Care Science
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba、Japan
Correspondence：

Kyoko Yajima

E-mail Adｄress： kodomonokokoro@nifty.com

Abstract
With increasing numbers of mothers affected by anxiety and stress relating to child care as well as the
problem of increasing numbers of abuse cases, support is needed to help mothers develop child-careconfidence and alleviate the stress of parenting.
In this study, a 90-minute lecture on child-care support was held for a group of mothers with infants (n=31).
The lecture comprised the essential needs of the soul support method utilizing the SAT theory-based guidance
method and reward-system images. The purpose of the study was to examine 1) the perceived child-careconfidence of child-rearing mothers and the short-term effects of stress reduction around the time of theintervention, and 2) the extended effects for three month after the intervention.
The results were: 1) around the time of the intervention, significant improvements were observed in thelevel of self-esteem, emotional support network, child-care confidence, self-repression, depression andsubjective stress, while a significant reduction was observed in the cortisol level of the saliva; and 2) the3extended effects were raised levels of self-esteem and child-care confidence, and a significant, continual
reduction in depression level. Compared with the pre-intervention period, the anxiety trait was significantly lower
in the analysis conducted three months after the intervention.
These results suggest that a group intervention using the essential needs of soul support method iscapable of increasing mental health conditions and child-care confidence, and providing support for the
reduction of child-care anxiety and stress

Key words: child-care support, essential needs of soul support method, self-esteem, child-care confidence,
image-script

I. Introduction
Accompanying the reduction in the number of live births and spread of the nuclear family starting in the
1980s, the number of mothers suffering from child rearing anxiety and parenting stress began to increase andthe rise in child abuse cases became a serious issue. The number of child abuse cases increased by nearly 17
fold, from 1,961 cases in 1994 to 32,979 cases in 2004, with those cases involving the biological motheraccounting for the largest number of child abuse cases.1) Child-rearing anxiety is one cause of parenting stress,
2) 3) and child rearing anxiety coupled with lack of confidence is believed to lead to child abuse.4)

The government has adopted various measures to tackle these problems, including the Angel Plan, the
New Angel Plan, Sukoyaka (i.e., healthy and happy) Family 21, Plus One Proposal to End the Falling Birthrate,and Support for Nurturing the Next Generation. At the community level, support measures include setting up
child-rearing support centers and family support centers that provide, among other things, a place of recreation
4

and relaxation for parents and children alike and a place where mothers can drop off their children while they goout.
In an intervention study of home visitations by nursing professionals to provide postpartum care one
month after childbirth, over 90 percent of the participating mothers said that the visitations were useful, as they
helped reduce their anxiety and improve their self-confidence, thus suggesting that home visitations by nursing
professionals serve as an effective support for child-rearing mothers.5) By contrast, in a study of a pediatrician
who provided child-rearing guidance in a class for child-rearing mothers, mothers with one month or younger
babies said that the guidance did not help reduce their child-rearing anxiety.6) A study conducted in a parenting
course attended by six mothers suffering from child-rearing anxiety found that although action group work
designed to help these mothers develop an effective coping behavior toward their children helped increased
their knowledge about behavior modification, it did not result in any systematic change in their actual coping
behavior toward child rearing.7) Such conventional methods of providing support are basically conduit for
conveying knowledge and information for reducing anxiety or stop-gap measures mainly designed to bringabout behavioral modification. Thus support is clearly needed to help mothers reduce child-rearing anxiety andstress in a fundamental way.
Stress is perceived when things do not turn as expected, 8) and today’s perception is related to theimage-scripts generated by past images. 9) According to T. Munakata, 9) our perception or understanding ofreality or future predictions are based on scripts that are reconstructed to match our expectations (predictions)drawn from our past knowledge and experience. Additionally, Munakata refers to (i) images based on sensory
information input from all sensory spheres (including the sense of smell, taste and balance, somatic sensations,5etc.) and images based on sensory information (including sadness, enjoyment, fear, etc.) that generates value
by being stored in the amygdala, and (ii) images based on stories of behavioral information output from these
two sets of images as image-scripts. Munakata then points out that today’s self-image-scripts are triggered bymemories of past images rooted in the growth environment of one’s parents.
Image memories differ depending on whether the essential needs of the soul are fulfilled or not.
According to the essential needs of the soul theory, 9) human beings possess three basic needs of the soul
expressed: (a) “I want my own needs to be fulfilled with other person’s love”; (b) “I want to develop self
confidence so I can fulfill my needs by myself”; and (3) “I want to fulfill other people’s needs unconditionally with
my own love.” A negative image of unfulfilled essential needs of the soul formed in the growth environment andthe like stored in the amygdala will develop into a trauma, which in turn will make a person more prone todevelop a negative self image-script. 9) Removing a negative self-images script is difficult once it has been
formed, and the presence of a negative self image-script makes a person more prone to perceive each of thevarious stimuli provided by the environment as stress.
It is common knowledge that when a stimulus is perceived as stress, CRH (corticotropin-releasing
hormone), which induces the secretion of ACTH (adrenocorticotropic hormone), is released from the
hypothalamic area of the brain, ACTH is secreted from the pituitary gland, and the stress hormone cotisol issecreted from the adrenal cortex. 10) Since the cortisol level in the blood is quickly reflected in the cortisol levelin the saliva, 11) in recent years, four separate studies have been conducted to measure the cortisol level in thesaliva as a stress indicator, 12-15) All four studies found a correlation between the rise in the cortisol level and theincrease in stress. Thus it is believed that cortisol triggers a variety of diseases. 9)
6

From the perspective of the cerebral nervous system, an image is a transfer pattern of a cranial nerve
circuit formed when two neurons are joined at a synapse. 9) The SAT theory asserts that the synopsis
connections are strengthened through the creation of cranial nerve activity patterns. These patterns are
created (i) by forming a reward-system (positive) image-script that satisfies the cranial nerve activity patterns fora cranial nerve activity pattern that up to now responded only negatively to external stimuli because the essential
needs of the soul were not satisfied, and (ii) by acting repeatedly on the basis of that positive image-script over along period of time.9) Under this SAT theory, counseling utilizing images that support behavioral modification andself-growth is provided on a daily basis, resulting in reduced stress.16) Past studies have confirmed theeffectiveness of individual counseling in improving the child-rearing mother’s self-esteem and child-careconfidence. In order to lower the level of anxiety and stress of child-rearing mothers, it is hoped a support
method will be designed to raise the level of their child-care confidence and self-esteem. 17)
This study examines, both quantitatively and qualitatively, the short-term effects of intervention and theirextended effects three months after the intervention. The objective is to reduce stress and improve child-careconfidence for groups of child-rearing mothers in a fundamental way. The intervention is carried out by using theessential needs of soul support method using a guidance method based on the theory and technique of SAT
support method and the reward-system images that fulfill the essential needs of the soul.

II. Research Methods
1. Targets and survey methods
With the cooperation of the healthcare center of Town A, Prefecture S, a group of child-rearing mothers
7were selected as the intervention group using a snowball sampling technique and urged them to participate in a“child-rearing support course.” A total of 31 child-rearing mothers participated in the course, five of whom
either came late or were not rearing a child at the time of the intervention. Thus 26 of the 31 participants (84%)
were targeted for the analyses. Sixteen of the original participants (62%) cooperated in the analyses conducted
three-month after the intervention.
With the cooperation of the Town A health center, the same snowball sampling method was used to
select a group of child-rearing mothers as the non-intervention group and the first survey was conducted while
the intervention group was participating in the child-rearing support course. Questionnaires were distributed to all
17 mothers of the intervention group. They all filled out the questionnaires and returned them. Sevenchild-rearing mothers (41%) cooperated in the second survey, which was timed to dovetail with the three-monthafter analysis of the intervention group.
For the intervention group, the pre-course questionnaires and post-intervention questionnaires werecollected in individual envelopes before and after the course, respectively. For the non-intervention group, thequestionnaires were distributed at the healthcare center and collected in individual envelopes. In the survey
conducted three months after the intervention, a questionnaire packet enclosed with a return envelope and awritten request for cooperation was mailed out to each participant and collected through the mail. The survey
was conducted over a period of three months, from August to November 2004.
In this study, around the time of the intervention, samples of saliva were taken using the essential needsof soul support method to measure the cortisol level in the saliva of the participants as a stress indicator. Since
saliva secretion reacts sensitively to stress, the saliva sampling was taken during rest hours.
8Out of ethical consideration, this study was subject to epidemiological review by the Tsukuba University
Ethics Committee and approved. Before implementation, among other things, the authors explained in writingthat the objective of the study and stressed that cooperation in the study was optional, that the respondents were
free to decide whether to put down their names or not, that the answers they write down should reflect their own
views, and that the collected data will be treated quantitatively. For those participating in the child-rearing support
course, the authors verbally explained the purpose of the course and asked for cooperation. The participants
agreed to cooperate. Those in the intervention group were asked to submit a certificate of consent, which theydid.
The standardized Japanese versions of two existing psychological scales were used: the State Trait
Anxiety Inventory 18) and the Self-Rating Depression Scale. 19 The developers of both scales consented to theauthors’ request to utilize them.

2. Composition of the questionnaire
The questionnaire consists of existing psychological scales on child-care confidence, and child-careanxiety (whose attributes, reliability and validity have been reviewed). Table 1 shows the contents of the scales
and the alpha coefficients ascertained in the study.

9

Table １ Composition of the questionnaire
Scale

Developed
Rosenberg 1965,Japaneseversion Munakata et al 1987

Item

Score

10

0〜10 Measures the degree of affirmative self-image.

.860

2 Self-repression

Munakata 1996

10

Measures the inclination to repress one's feeling or
0〜20 thoughts so that others do not come to dislike theindividual.

.772

3 Emotional support network

Munakata 1996

10

0〜10

Measures the degree of awareness of emotional
support from family and others,respectively.

.854

4 Problem-solving

Munakata 1990

10

0〜20

Measures the tendency towerd effective andpositive problem-solving.

.652

18

0〜18

Measures the degree of excessive interpersonal
dependency.

.742

1 Self-esteemContent of measurement

α coefficient20

20〜80 Measures the tendency to feel anxious.

7 Depression（SDS）

Hirschfeld1977,compiled by
P.McDonald Scott
Spielberger 1970,compiled by
Mizuguti et al
Zung 1965 compiled by Hukuda

20

20〜80 Measures the tendency towerds depression.

.841

8 Child-care confidence

Yajima et al 2004

10

10〜40 Measures the degree of the child-care confidence.

.880

9 Child-care anxietry

Extraction from Profile-scaleby Kawai et al 199713

13〜52 Measures the degree of the child-care anxietry.

.853

5 Interpersonal dependency
6 Trait anxietry（STAI）

3. Method of intervention
The intervention was conducted by two SAT counselors licensed by the Academy of Health Counseling.
The intervention lasted 90 minutes – 30 minutes for guidance, 45 minutes for on-site training, and 15 minutes forfilling out the post-intervention questionnaire.

4. Contents of the Intervention(1) The intervention involved on-site training using the method of communication with children based on SAT
therapy, the essential needs of soul theory, the guidance based on the flashback theory, and the essential needsof soul support method.

(2) What is the essential needs of soul support method?
The essential needs of soul support method is based on the essential needs of soul theory. The method
10

.912

is built from the three techniques discussed below to help child-rearing mothers cope with the problems they
currently face by (a) creating a positive image-script that fulfills the essential needs of the soul that are at preset
unfulfilled, and (b) by using the positive image-script formed with the essential needs of soul method even if
there is a negative image-script that flashes back, and forth between past and future at the time of stressperception. Additionally, free-description sheets used to have the participants indicate for each of the threetechniques discussed below their subjective stress levels, their impressions, and the way they cope with stress.
(a) Making physical contact: In this technique, the participants, in pairs, empathetically make physical contact.
This is done by imagining the person one loves with the region or force one prefers and in such a way that asignal of unconditional love is sent from one’s hand to the hand of the person one is paired with.
Noradrenalin is secreted when stress is perceived, and this causes symptoms to appear in various regionsof the body. 9) The physical contact technique aims to control negative emotions, promote pleasurable
sensations and reduce the present somatic symptoms by inducing the release of dopamine and serotoninfrom the brain by producing somatosensory stimuli through physical contact.

(b) Forming a favorable inner-womb image and love signaling method: These techniques aim to help theparticipants fulfill the essential needs of their soul by having them create a favorable image of themselves intheir mother’s womb by applying structured regressive hypnosis and offering words that convey a signal oflove so that the participants will be able to hold a positive image-script, and thereby weaken the flashback ofnegative images from the past and also apply that same positive image-script for the coming child.

11(c) Forming a future self-image: This technique aims to fulfill the essential needs of the soul by creating andforming an image of the self enjoying life and living with exuberance and full of confidence. The techniquealso aims to help child-rearing mothers perceive the self acting in accordance with one’s own values
believes.

5. Analytical method
The survey results were analyzed using the statistics analysis software SPSS Ver. 11.0. The Friedman
test was then administered to evaluate changes in the participants’ subjective stress level during the intervention,
the effects of psychological traits on their stress level around the time of the intervention, and the extended
effects of the intervention. For the purpose of multiple comparisons, after administering the Wilcoxon codedranking test, corrections were made using the Bonferroni inequalities

III. Findings
1. Average psychological trait values of child-rearing mothers
Average psychological trait values of a total of 43 child-rearing mothers (belonging to either theintervention group or to the non-intervention group) were calculated and the following results were obtained: theself-esteem level rose 6.16 points; the self-suppression behavioral trait level, 9.14 points; the emotional support
network family level, 8.53 points; the other than family level, 8.14 points; the problem solving behavioral trait level,
10.44 points; the interpersonal dependence type behavioral trait level, 6.53 points; and the trait anxiety level,
43.86 points
122. Comparison of the basic attributes and psychological trait of mothers in the intervention group and those in
the non-intervention group

Table 2 shows the results of the Mann-Whitney test on the intervention and non-intervention groups
administered to determine whether it is possible for the non-intervention group to serve as the control group interms of basic attributes and psychological traits. Although differences were observed in the case of the mother’s
age and the age of her spouse, no significant differences were found in the case of other items. Thus it was
concluded that the non-intervention group cannot serve as the control group.

Table 2 Comparison of the basic attributes and psychological traits of mothers in the intervention group andthose in the non-intervention group,changes around the time of the intervention(intervention group ｎ=26、nonintervention group ｎ=17)

Age of person in questionAge of consort
Number of those who cohabit
Number of children
Self-esteem
Self-repression
Emotional support network(family)
Emotional support network(others)
Problem-solving
Interpersonal dependency
Trait anxietry（STAI）
Depression（SDS）
Child-care confidenceChild-care anxietry
Cortisol level in the saliva

Intervention group
Mean value
Mean value
before intervention
after intervention
32.12（±4.11）
34.81（±5.93）
4.50（±1.50）
1.58（±0.86）
5.96（±2.76） 8.04（±2.03）
9.58（±3.36） 8.77（±2.70）
8.58（±2.04） 9.35（±1.55）
8.12（±2.49） 8.81（±2.25）
10.58（±3.01） 10.27（±2.66）
6.77（±3.37） 6.35（±3.69）
43.12（±11.43） 41.65（±10.80）
40.15（±9.02） 37.46（±7.55）
26.46（±5.37） 29.81（±4.61）
23.19（±6.42） 23.50（±7.00）
0.28（±0.12） 0.23（±0.09）

Non-intervention group Both crowd comparison
p-value

.000
.070
.007
.007
.542
.289
.252
.005
.000
.806
.002

beforep-value

28.94（±2.33）
30.88（±3.36）
4.06（±1.44）
1.41（±0.51）
6.47（±2.38）
9.18（±3.43）
8.48（±2.50)
8.18（±2.63）
10.24（±2.56）
6.29（±3.18）
45.12（±9.56）
41.12（±7.96）
28.41（±4.29）
21.76（±4.86）

.013
.049
.305
.819
.707
.644
.883
.655
.515
.546
.384
.645
.178
.508

3. Changes in psychological traits and child-care self confidence around the time of the intervention
Changes in psychological traits around the time of the intervention are shown in Table 2. After theintervention, the average score rose significantly for self-esteem, family with perceived emotional support, other13

than family, and child-care confidence, while the average score for depression and self-suppression behavioral
traits tended to decline. However, no significant differences were found around the intervention for problem
solving behavioral traits, interpersonal behavioral traits, anxiety traits, and child-care anxiety.

4. Changes in the subjective stress level during the intervention using the essential needs of soul support
method.

Figure 1 shows the results of an assay of descriptions of stress levels the participants wrote down in the freedescription sheets distributed to them to determine the effect of the intervention on their subjective stress levelaround the time of the intervention. The average value of the subjective stress levels before the intervention
declined significantly in each technique.
Figure 1

Changes in the subjective stress level during the intervention（ ｎ ＝26）

％
100

＊＊＊
＊＊＊

80
＊＊＊
＊＊＊

60

65.3

†
＊＊＊

40

39.6

32.6

20

23.3

0
beforeintervention

Friedman：ｐ＝.000

after the physicalcontact

after thafavorable innerwomb image andlove signaling
method14

post hoc test(Bonferroni)

after the futureself-image＊＊＊：ｐ＜.001†：ｐ＜.1

5. Regarding the change in cortisol level in the saliva around the time of the intervention using the essential
needs of soul support method

The cortisol level in the saliva was measured to ascertain the effects of the intervention around the time of theintervention. After the intervention with the essential needs of sour support method, the cortisol level in the saliva
declined significantly (Table 2). Additionally, correlational analyses (Speaman) were conducted to observe therelationship between the cortisol level and the variation in the psychological traits around the time of theintervention (ρ=.440 p=.024) and the variation in the child-care anxiety level (ρ=.404 p=.01)

6. Comparison of the psychological traits of child-rearing mothers in the intervention group and those in the
non-intervention group before the intervention and three months after the intervention

With regard to the intervention group (n=16) and the non-intervention group (n=7), the average value of
psychological traits before the intervention and three months after were compared. The age of the child-rearing
mothers in the non-intervention group was significantly lower (intervention group: 32.131 [±4.34] years old;
non-intervention group: 28.14 (±2.4) years old, p=0.21). Before the intervention, the average child-careconfidence level tended to be significantly higher for the non-intervention group (p=003) and the average15depression level tended to be lower (p=056). Three months after the intervention, no significant difference wasobserved between the two groups (for the scores obtained, see Tables 3 and 4).

Table 3 Change of the psychological traits in the intervention group before and three months after the intervention（ｎ＝16）
Mean valueFriedman①−③①−②①before②after
③three months afterSelf-esteem
5.13（±2.94） 7.75（±2.38）
6.56（±2.58）
Self-repression
10.13（±3.38） 9.06（±2.89）
9.31（±2.92）
Emotional support network(family) 8.25（±2.11） 9.25（±1.81）
7.94（±2.91）
Emotional support network(others) 7.69（±2.94） 8.56（±2.76）
7.75（±3.53）
Problem-solving
10.25（±3.36） 10.25（±2.84） 10.13（±4.67）
Interpersonal dependency
7.06（±3.42） 6.63（±3.67）
5.94（±4.01）
Trait anxietry（STAI）
46.88（±12.37） 44.25（±12.20） 43.50（±11.79）
Depression（SDS）
43.94（±8.04） 40.38（±7.50） 40.25（±8.93）
Child-care confidence
24.25（±5.30） 28.38（±4.84） 27.00（±4.24）
Child-care anxietry
25.38（±7.11） 25.63（±7.70） 24.13（±6.89）

p-value
.000
.601
.111
.067
.645
.154
.219
.004
.002
.442

Bonferroni
ｐ<.01

Bonferroni
ｐ<.01

ｐ<.05
ｐ<.01

ｐ<.05
ｐ<.05

Table 4 Change of the psychological traits in the non-intervention group before
and three months after the intervention（ｎ＝7）
Non-intervention group
Mean value three
Mean value before
p-valuemonths after
28.14（±2.04）
Age of person in question
Self-esteem
7.14（±2.27）
7.86（±2.41）.059
9.71（±3.04）
9.57（±3.41）
1.000
Self-repression
Emotional support network(family)
9.43（±1.13）
9.57（±0.79）.317
8.71（±2.63）
9.14（±1.57）.317
Emotional support network(others)
Problem-solving
10.86（±1.46）
9.57（±1.72）.202
Interpersonal dependency
5.43（±0.98）
7.14（±3.13）.140
41.86（±6.31）
37.86（±10.29）.223
Trait anxietry（STAI）
Depression（SDS）
36.71（±6.24）
36.00（±7.72）.674
30.29（±2.93）
30.43（±3.46）.891
Child-care confidenceChild-care anxietry
22.86（±5.40）
21.43（±6.73）.352

7. With regard to the extended effects for three months after the intervention

In order to measure the extended effects of intervention in the intervention group, the effects were measured
before, immediately after, and three months after the intervention. Improvements in self esteem and child-care16

confidence and decline in depression were sustained at a significant level for three months after the intervention(Table 3). In the non-intervention group, no significant change was observed (Table 4).

8. Change in the mother’s subjective stress level three months after the intervention

Table 5 shows (a) all the cases involving the subjective stress of child rearing written in the free-description

17

18

sheets during the intervention using the essential needs of soul support model, and (b) the stress coping
methods and changes in the mother’s attitude toward the child described in the survey three-month after theintervention.

IV. Discussion
In this study, direct intervention of a group of child-rearing mothers was implemented by applying the SAT
theory-based guidance method and the essential needs support method. The effects of the intervention wasthen examined, both quantitatively and qualitatively, on the basis of the changes in the psychological traits of thechild-rearing mothers observed around the time of the intervention and three months after the intervention, as
well as on the basis of the impressions they wrote down in the free-description sheets.

1. Regarding the present state of child-rearing mothers
Child rearing is a regular part of life, but at the same time, it is said that a child-rearing mother is in apeculiar situation characterized by many stressors. Stress is perceived when things do not go as expected, andwhen a stress is perceived negatively, self control of feelings, behaviors and bodily functions declines, resulting
in the appearance of somatic, behavioral and neurological symptoms. 8)
The subjective stress that emerges from the free descriptions provided by the child-rearing mothers in the
study shows neurological symptoms such as: “I get irritated when I compare my baby with other babies”; “I
become irritated and lose my temper when my baby doesn’t listen to me”; or “I become irritated when I can’t do
the household chores [because I have to take care of my baby].” The mothers’ subjective stress is also19manifested in behavioral symptoms such as: ”I get mad at my baby easily”; “I find myself shouting at my baby”;
and “I often hit my baby.” With regard to somatic symptoms, in the free description distributed during theintervention, the participants were asked write down where they felt most uncomfortable when they were understress. Their answers contained a large range of symptoms including stiff shoulders, stomach ache, lower backproblem and headache. From these stress symptoms, it is possible to infer that child-rearing mothers are undera lot of stress.
The self-esteem of mothers in this study was 6 points, and from the interpretation of this measure, 21)mothers in this study have low self-esteem and negative self-image. And given that their average value for trait
anxiety was 44 points, (which is considered high), while their average value for depression was 40 points, (whichmeans they are in a light depression territory), it is hardly possible to say that the mothers in this study are ingood mental health. It is can be assumed that the mothers’ stress symptoms and poor mental health, conveyed
either directly or indirectly through their expressions, tone of voice, attitude and so on, have a negative impact on
their children. 22) 32)

2. Regarding the intervention’s short-term effects
After the intervention using the essential needs of support method, the self-esteem level, awareness ofemotional support level and child-care confidence level were improved, while the self-repression level anddepression level were lower.
Stress is closely related to the image of the situation that has triggered the stress. According to a reportby Hashimoto et al, 24) in image research it is said that when one has a good image of one’s parents, one tends

20to also have a good self-image, and good self-image is said to be conducive good mental health, but no study
has been done to determine how self-image can be improved. Additionally, according to a study by Higuchi et al,25) there is evidence that having a positive image-script of one’s parents has an effect of changing one’s mental

health in a favorable way. Group intervention was carried out in this study with the view to improving theparticipating mothers’ self-image and the image of their parents by using the SAT physical contact method,favorable inner-womb image method, love signaling method, and future self-image method.
The somatosensory stimulus triggered by physical contact releases dopamine and serotonin from thebrain, which in turn repress negative emotions and heighten the feeling of pleasure, thereby reducing stress. 20)
The SAT physical contact method used in carrying out the intervention of this study works directly on the painand discomfort the body feels when it is under stress. First, the participants are instructed to form an image ofthe stress they currently feel and perceive the discomfort and pain felt by the body, and reduce the discomfort
and pain by instinctively answering the question “What part of the body do you want me to stroke?” These steps
activate the intuitive faculties of the brain’s right hemisphere in a manner peculiar to the SAT method. Stroking
the other party endearingly where she wants to be stroked and with the amount of force she desires releases
serotonin in the brain, thereby easing the stress felt by the body. This reduction of the stress felt by the body isbelieved to be what enables the patient to feel psychologically good or relaxed. The level of subjective stress is
reduced to its lowest level after the physical contact. The impressions the participants had after the psychicalcontact included “I feel comfortable”; “I feel relaxed”; “I feel lighter”; and “I feel safe,” suggesting that theintervention using the SAT physical contact method had the desired effects. It is believed that the support ofothers can be perceived by experiencing a feeling of comfortableness and feeling of security through the touch21

by others, thus raising awareness of the emotional support being provided.
The awareness and emotions one has today are influenced by the past and future images that exist in
the subconscious. One is unable to exercise self-control when one develops stress because there is a flashbackof negative images stored in the mind. 9) However, in the SAT theory-based guidance method or image therapy,
support is provided to help patients modify their behaviors or achieve self-growth usually by urging them to recall
images of past traumas and transform their negative image-scripts to positive ones. However, in the groupintervention conducted for this study, the participants are urged to form a positive image-script from theinner-womb stage to the infant stage without having to recall past traumas by using the favorable inner-womb
image method and love signaling method. Images represent cranial nerve activity patterns, and for the brain,
whether the images are perceived images rooted in experience or imagined, and even if they contain different
quantities of information, the path through which the brain is aroused is the same.9) That is to say, forming
imagined images using the favorable inner-womb method and love signaling method enables one to freshly
form cranial nerve activity patterns of positive images of being amply loved and accepted from the inner-womb
period to the infant stage. Recalling an image of being loved in the past enables some people to change theimage they have of their parents and even their own self images in a favorable way, thus in turn enabling themto improve their self esteem.
In addition, the present is also influenced by future images. If one is able to imagine the future in apositive way, one will also be able to perceive the present in a positive way. 9) The future image method usedin this study guides the child-rearing mother to imagine the future and form a fresh positive image-script basedon that imagined image of the future. According to humanistic psychology, 26) 27) human are by nature22autonomous beings with goals and values and are capable of self-determination, and mental health is realized in
the process of self-realization. However, it is probably the case that the degree to which one is able to hold afavorable self-image plays a part in self-determination that makes self-realization possible. It is believed that bydeveloping a positive image-script in which the future self is portrayed as free and self-confident, one is able toperceive the self in its true light and the self-image is changed in a favorable way, that is, in a way that shows theself able to choose a way of life that holds the self dearly, thereby improving one’s mental health and lowering
depression.
Earlier it was pointed out that the essential needs of soul support method is a support method that fulfills
three basic needs. According to Munakata’s soul development theory, 28) the period between infant and laterchildhood is the period when one is recognized and loved by a significant other (fulfillment of the desire to be
loved). Munakata cites the inability of one’s parents, one’s first significant others, to resolve the problems ofself-repression and dependence of their souls as a factor that prevents resolution of problems that arise when
one is an infant. Self-repression and reliance on others are formed by a feeling of being affection-deprived or
receiving only conditional love (as opposed to unconditional love) in the process of growing up. That is to say, by
not being loved unconditionally by one’s significant others in the process of growing up, the parents themselves
developed a proclivity to suppress their feelings and depend on others, which continued into their adulthood.
The mother herself is designed to fulfill her desire to be loved because she is so worried about how others viewher that she does not have her own standard of judgment, but has such a strong expectation of others that shelacks the confidence required for self-determination. Thus she is unable to give her children unconditional love,and finds herself shouting at them when they do not listen to her. The latter is a manifestation of her dependence23

on her children. Properly speaking, the level of self-repression and dependence on others need to be lowered
before these issues can be resolved. However, in this survey, although there was a tendency for the level ofself-repression to become significantly lower, there was no change in the average score on the dependence ofothers measure.
One reason there was no clear change in the self-repression level is that no self-assertion training wasprovided. The actual amount of housework and work related to child-rearing did not change. Since the soulwants self-repression, even if the wife feels a desire to have her husband help in child-rearing, she concludes
that she should not ask her husband to help. Because she is unable to ask, her desire to have her husband
understand how hard it is to keep the house and at the same time raise children and the sense that she wants
him to help remains unfulfilled. Moreover, limiting its objective to clarifying the nature of stress in child rearing, thesurvey clarified the impressions the participating mothers gave for each support method, their method of copingwith stress and awareness of its presence, and in the process of clarifying these points, the participating mothers
developed the skills for making physical contact with their children as a way of coping with stress. However, it isunclear whether the intensity of the feeling of dependence on others as expressed by their desire to get their
toddlers to listen was completely reduced, although evidence suggests it remains. Thus it can be inferred that inthis survey the score on the dependence on others measure did not change, and it can be expected that thelevel of self-repression and dependence on others may be lowered by repeatedly applying the essential needsof soul support method.
In this study, in order to measure the stress reduction effect of the essential needs of support method, thecortisol level in the saliva of the participating mothers was measured around the time of the intervention. The
24

standard cortisol level in the saliva is said to range in the vicinity of 0.03 to 0.2 μ g/d 1 with the level being high inthe morning and low in the evening.10) In this study, a quiet rest time was provided to eliminate the impact of
the rise in the stress level at the time the participating mothers arrived at the health center. The cortisol level foreach participant was measured at around 11 am (before intervention) and around 11 pm (after intervention).
Thus the impact of the time of the day factor was kept to a minimum. The average cortisol level in the saliva of
the participating mothers was 0.28 μ g/d 1, suggesting that the mothers targeted in this study were under stress.
The cortisol levels in their saliva were significantly lower after the intervention. In addition, a correlational analysisof the degree of change around the time of the intervention found a correlation between the degree of change inthe trait anxiety level and the degree of change in the child-care anxiety level, suggesting that the essential
needs of soul support method was effective in reducing the psychological stress of child-bearing mothers.
According to the contents of the descriptions entered in the free-description sheets distributed during theintervention using the essential of soul support method, the average subjective stress level before theintervention was 64.5%, but it declined to 39.6% after the physical contact intervention and to 32.6% after theapplication of the inner-womb image method. Then, after the future self-image method was applied, it declined
significantly to 23.4%. As a result of these changes, together with the decline of the cortisol level in the saliva, it
can be inferred that the intervention had an effect in reducing the stress perceived at the present. Moreover,since the individual techniques were all effective in reducing stress, intervention using one of the techniques isbelieved possible.

2. Regarding the extended effects of intervention
25

Quantitative changes in psychological traits and child-care confidence and quantitative changes in
attitude toward children, both recorded three months after the intervention, as well as changes in stress levels
achieved through the application of stress-coping methods were studied qualitatively. In the quantitative changes,
improvements in self-esteem and child-care confidence as well as the declines in depression were sustained
significantly. Around the time of the intervention, the child-care confidence level of the intervention group was
significantly higher and their depression level was significantly lower, while mothers in the non-intervention groupwere caring for their children with more confident and less stress. Three months after the intervention, the levelof self-esteem tended to rise significantly in the non-intervention group, but there was no statistically significant
difference between the two groups. It can be inferred from this that there was no significant difference precisely
because significant improvements in self-esteem and child-care confidence and a significant decline indepression were both sustained among those in the non-intervention group. Moreover, changes in attitude
toward one’s children and changes in actions taken toward oneself could be inferred from the responses thechild-rearing mothers gave in the questionnaire survey conducted three months after the intervention, Thissuggests that, based on quantitative and qualitative analyses of the data, the essential needs of support method
has the extended effect of improving the levels of self-esteem and child-care confidence, thereby reducing
child-rearing anxiety and stress of mothers.
The participating mothers said that they felt comfortable and safe after the intervention using the SAT
physical contact. Given that the state of a mother’s soul impacts her attitude toward child-rearing, Hashimoto S.
29) states that child-rearing mothers should create an environment where their children can feel reassured andreceive safe and unshakable love unconditionally by (i) sending out a lot of messages of unconditional love, (ii)26realizing their susceptibility to respond emotionally to suit their own convenience, and (iii) letting their children go
through experiences that will fulfill the three basic desires of their soul. It is believed that to be able to send out
safe and reassuring signals to their children, first of all, mothers need to be able to relax as when the physicalcontact method is applied. Moreover, although physical contact with babies, such as the post-delivery kangaroocare and touch care, are stressed, 30) it is believed that knowing how good it feels to have physical contact
enables mothers to hug their own children. However, in the questionnaire survey conducted three months after
the intervention, the participating mothers said they changed their behavior, as in: “I hugged my daughter when
she crawled close to my feet”; “I hug my daughter even though she’s in school now.”Moreover, from the viewpoint of what Hashimoto S. terms “the ease with which mothers respondemotionally to suit their own convenience,” 29) it is significant that the participating mothers made such comments
as: “I lose my temper, despite myself, and end up screaming at my baby”; “The more difficulty I have figuring out
what’s making me angry, the more angry I get”; and “When I’m inundated with housekeeping chores, I get
irritated and find myself scolding my baby.” But three months after the intervention, the same mothers showedbehavioral modification, that is, changed the way they thought about their kids, the way they expressed their love
for them, and how they accepted them into their heart. Here are some examples “I’ve learned to see things frommy child’s perspective. I pause to take breaths to control my anger and avoid unilaterally scolding him”; “Mybaby seems much cuter than before”: “I’m more sensitive to my baby’s needs now than I used to be.” “When I’m
about to lose my temper, I take a deep breath and recall my childhood days when I was really loved. I do mybest to slow down and relax more.”
The reason the intervention had positive effects may be that the significant rise in self-esteem level and27

child-care confidence level, coupled with the significant reduction in depression level, enabled mothers to be
more relaxed with their babies, thus rendering the interaction between mother and child more comforting。
Additionally, as can be see by the comment, “Recalling the words used in the love signaling method at a time
when I was irritated enabled me to show real affection for my baby, which I couldn’t do before,” even whenmothers had flashbacks of negative images, by repeatedly changing their attitude toward their children by
applying the positive image-script formed in their minds further strengthened that active pattern and enabledmothers to continue forming the positive image-script even three months after the intervention.
Three months after the intervention, not only was there modification in the mothers’ behavioral toward
their babies, there was also modification in the mothers’ behavior toward themselves. The mothers continued tobehave in a way that placed importance on the self, as in “Now I’m interested in things other than raising mybaby. When the baby’s asleep, I read a newspaper or a book I’ve wanted to read. I’ve pulled myself together, so
now, I can as a human being, calmly face my baby,” or “I’ve taken up something I’ve always wanted to do.” “I set
aside time to be alone,” or “For a change of air, I take my baby to a park or take her out with me.” This suggeststhat undergoing the intervention using the future self-imaging method helped the mothers find what they reallywant to do, thus enabling them to modify their behavior.
It is believed that, thanks to these favorable behavioral modifications, the mothers in the intervention
group were able to continue to direct their coping behavior at their children and at themselves, resulting in thecontinued improvement of self-esteem and child-care confidence, thereby enabling these mothers to continue
lowering their depression level. Regarding child care anxiety, Kawai N. et al 17) believes that, since mothers’
psychosomatic condition is related to the psychosomatic condition of their children, their tendency to be anxious
28

about child-rearing is believed to originate in their lack of self-esteem and feeling of incompetence andhelplessness. Kawai et al point out the necessity of intervention centering on assistance to mothers to develop aproper sense of motherhood, and it can be said that the essential needs of soul support method, which supports
the change in lifestyle to one that places importance on the mother’s attitude towards her child and herself byincreasing her self-esteem and child-care confidence, is precisely the kind of support designed to assist mothers
to develop such a sense of motherhood.
The foregoing discussion describes the extended effects of the essential needs of soul support method,
but it is unreasonable to think that the method, as it is, will be effective for everyone. Consequently, for improving
the essential needs of soul support method, it is important to examine the cases where mothers were not able toeffect behavioral modifications either towards their child or toward themselves.
In case 12 of the analysis conducted three months after the intervention, the mother remarked, “I had myhusband read the description I wrote down. I think that helped him understand why I was so stressed out caring
for our baby.” But the mother did not say that the intervention helped change their behavior toward themselvesor their children. In case 13, the mother said, “The situation has not changed,” showing that the intervention was
not effective. The psychological traits that characterize case 12 were: low levels of self-esteem, emotional
support awareness, child-care confidence, and high levels of self-repression, problem avoidance, reliance onothers, trait anxiety, depression, and child-care anxiety. An infant treated for a psychogenetic visual impairment iscited in a study undertaken by Higuchi N. et al. 25) Right after the treatment, the mother showed some signs ofimprovement, but later relapsed. She manifested the following characteristics: a high level of anxiety,self-repression, and reliance on others, and a low level of self-esteem and support awareness. These are the29characteristics of mothers who did not show any extended effects three months after the intervention, but they
resemble those observed in case 12. The mother in case 12 wrote down in her free-description sheet, “I recall
being alone as a child,” suggesting that she has a negative image of her parents as she grew up.
The psychological traits that characterize case 13 were: a low level of reliance on other and a high levelof problem avoidance, and a low level of child-care confidence. The mother acts in ways that avoid problem
solving, as in: “I’m overwhelmed by what I have to do every day” and “I clean the house just to relieve stress, ortake my baby out to a department store or the like where we just walk around.” Here, the mother seems neither
to understand nor accept how the child feels, as when she says, “I gets emotional and take it out on my kid.” In
her free-description sheet, the mother remarks, “I end up recalling my real parents and the environment I grew
up in, and marvel at how lucky babies are when they are brought into this world by parents who love them as
depicted by this image,” reflecting the negative image she has of her parents.
Common to these two cases where neither mothers got good results from the intervention is that theyboth have negative images of their parents in the environment they grew up in, and frequently resort to problem
avoidance. The high level of problem avoidance means that these mothers are so anxious about child-rearingthat they are unable look straight at the problems. As a result, they are susceptible to becoming excessively
optimistic and are likely to turn their backs on reality on regular basis. 31)
From the foregoing discussion, the method of intervention adopted in this study by itself is believed to beinadequate to enable parents to solve their child-rearing problems if they have strong negative images ofthemselves going back when they were very young, including when they were in their mothers’ womb, and lackthe strength to look straight at and solve the problems they face. For children’s soul to develop, it is important
30

give them experience receiving ample amount of love during their fetal life and infancy. However, the love they
get from their parents must be unconditional love. To provide a safe and secured environment for their children
to grow in, mothers must be able to care for them with tender love. 29) Those mothers participating in this study
for whom the essential needs of support method proved effective apparently all had traumatic experiences
hidden in their subconsciousness.
In individual counseling cases, counseling provided is designed to meet the needs of the individual client,but since this study targeted groups rather than individuals, the intervention could not be customized to meet theneeds of individual participants. Using the essential needs of soul support method, together with thepersonalized SAT-based therapy support, was deemed effective in addressing the shortcomings of applying theessential needs of soul support method to groups.

V. Conclusions

1. After the intervention, the essential needs of soul support method used to provide guidance for child-rearing
mothers proved effective in significantly raising their self-esteem level, support awareness level and child-careconfidence level, and significantly lowering their depression level, cortisol level of the saliva and subjective stresslevel.
2. Three months after the intervention, the extended effects were favorable behavioral modifications towards
one’s children and towards oneself, higher levels of self-esteem and child-care confidence, and a lower
depression level.
31

3. The essential needs of soul support method using positive image-scripts based on quantitative andqualitative data analyses is believed to be effective in reducing stress borne by child-rearing mothers andimproving their confidence in caring for their children.

Acknowledgement
This study was conducted as a category B basic research of the Ministry of Education, Culture, Sports,
Science and Technology’s Grant-Aid for Scientific Research (Proposal No. 16300219; title: “A Study of aLong-Distance Support System for Sustained Health Behavior Using a Counseling Method for Supporting
Prevention of Lifestyle Diseases among Local Residents, Patients and Patients-to-Be,” Research Leader: Sayuri
Hashimoto. We would like to express our sincere gratitude to all who cooperated in this study.

Notes and References

1) “Kodomo no Karada to Kokoro,” Renraku Kaigi Hen: Kodomo no Karada to Kokoro Hakusho 2005,
Tokyo, 95-97 (2005)
2) Sakama, I., Yamazaki, K., Kawata, C., "Ikuji Sutoresu no Kitei Yoin ni kansuru Kenkyu,” Nihon
Koshueise-shi, 46 (4), 250-261 (1999)
3) Shimizu, K., Nishida, K., “Ikuji Sutoresu Kozo no Kenkyu,” Nihon Kaigo Kenkyuu Gakkai Zasshi, 23 (5),55-67 (2000)
4) Hattori, Y., Kanekawa, K., Harada, M., “Nyuyoji no Shinshin Hattatsu to Kankyo – Osaka Repoto to
Seishin Igaku-teki Shiten – ,“ Nagoya Daigaku Shuppankai, Nagoya, 14-22 (2003)
32

5) Tsuzuki, C., Kanewaka, K., “Sango Ikkagetsu-go no Hahaoya ni taisuru Kangoshoku ni yoru
Kateihomon no Koka – Hahaoya no Fuan to Ikuji ni taisuru Toraekata ni Shoten o Atete –,” Nihon
Koshueisei-shi, 49 (11), 1142-1151 (2002)
6) Yamamoto, J., Takabayashi, A., Iida, K., “Hahaoya Gakkyu he no Shonika-i no Kainyu to sono Kokano Kento,” Shonihoken Kenkyu, 58 (3), 423-427 (1999)
7)

Kuwata, S., “Ikuji Koza ni okeru Hahaoya he no Sosyaru Gurupu Waku (I),” Undo, Health Kyoiku
Kenkyu, 7 (2), 41-45 (1998)

8) Munakata, T., Sutoresu Kaisho-gaku, Shogakkan Raiburari, Tokyo, (1995)
9) Munakata, T., SAT Ryoho, Kaneko Shobo, Tokyo, 32-71 (2006)
10) Higuhi, T., “Sutoresu to Horumon,” Nihon Hikaku Naibupitsu Gakkai Hen, “Karada no naka kara
Sutoresu o Miru,” Gakkai Shuppan Senta, Tokyo, 71-91 (2000)
11) Morimoto, K., “Sutoresu Kiki no Yobo Igaku,” NHK Bukkusu, Tokyo, 141-144 (1997)12) Sakai, H., Sato, E., Koike, K., Shonozaki, T., Mizuochi, F., Goto, M., “Daeki de Sutoresu o Hakaru
Kokoromi,” Nihon Daigaku Shigaku-bu Kenkyu Kiyo, 26, 57-61(1998)
13) Abe, K., Abe, A., Honma, K., Wataname, Y., “Daeki Koruchizoru no Hendo o Shihyo to shihta Sutoresu
Hyoka to sono Oyo – Shogai no aru Hitobito no Supotsu Katsudo o Rei ni -,” Kansei Fukushi Kenkyujo
Nempo, 3, 75-79 (2002)
14) Higuchi, K., Daeki-chu Koruchizoru Sokutei ni yoru Sutoresu no Hantei,” Rongi, Adkita Keizai Hoka
Daigaku Tanki Daigaku-bu, 68, 85-89 (2001)15) Marilyn, J. E., Marjorie, H. K., Eunsuk, C., et al., “Maternal Stress Beginning in Infancy May Sensitize
33

Children to Later Stress Exposure: Effects on Cortizol and Behavior,” Society of Biological Psychiatry,52, 776-784 (2002)16) Munakata, T., ed., Kaunsering Iryo to Kenko, Kaneko Shobo, Tokyo, 29-194 (2004)
17) Kawai, N., Shoji, J., Chika, Y., Kato, H., Nakano, E., Tsuneji, K., “Ikuji Fuan ni kansuru Kisoteki Kento,”
Nihon Sogo Ai-iku Kenkyu Kiyo, 30, 27-39 (1994)18) Mizuguchi, K., Shimonaka, J., Nakazato, K., Nihongo-ban STAI Shiyo Tebiki, Sankyo Shobo,19) Fukuda, K., Kobayashi, S., Nihongo-ban STAI Shiyo Tebiki, Sankyo Shobo,20) Munakata, T., Jinsei o Risetto Shitai Anata ni, Mimatsu Co., Ltd., Tokyo, (200)21) Munakata, T., e., Herusu Kansuringu Jiten, Nagoya, 368-381 (1999)
22) Saito, E., “Boshi Rinsho no Tachiba kara, Kokoro,” Kokoro no Kagaku, 103, Nihon Hyoronsha, Tokyo,
36-43 (2002)
23) Watanabe, H., Boshi Rinsho to Sedaikan Dentatsu Kongo Shuppan, Tokyo, (2000)
24) Hashimoto, S., Nakano, T., “Ryoshin Imeji ga Jiko Imeji, ni kansuru Eikyo ni kansuru Chosa Kenkyu,”
Nihon Hoken Iryo Kodo Kagaku-kai, Nempo, 19, 121-138 (2004)
25) Higuchi, R., Munakata, T., Hashimoto, S., ISAT Ryoho ni yoru Shin-in Shikaku Shogai no Chiryo Yogo
ni kansuru Kenkyu,” Journal of Health Counseling, 9. 45-54 (2003)
26) Maslow, A. H., (translation by Koguchi, T.), Ningensei no Shinrigaku, Noritsu Daigaku Shuppan-bu,(1998)
27) Rogers C. R., (translation supervised by Ito, H. and Murayama, M.), Rojyasu Senshu (vol. 1) (vol. 2) ,Yomu Shobo, (2001)3428) Munakata, T., Kdomotachi wa Seicho Shitagatteiru! Koeisha, Tokyo, 182 (1998)29) Hashimoto, Sa., “Kokoro (Seishin) no Hattatsu,” Tanaka, H., ed., Nyuyojiki no Kenko, Nishinihon Hoki
Shuppan, Okayama, 23-46 (2004)
30) Horiuchi, K., Hashimoto, Y., Iida., Y., Kangaru Nukumori no Kosodate, Medika Shuppan, Tokyo, (1999)31) Munakata, T., SAT Kanunseringu Giho, Koeisha, Tokyo, (1997)35

Examining Effects of Human Relation Skill Using Genetic Temperament Concept on Stress
Management: 3-month-followup Intervention

Kyoko Tanaka and Tsunetsugu Munakata
Department of Human Care
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba
Correspondence: Tsunetsugu Munakata
D511 1-1-1 Tennoudai, Tsukuba, Japan 305-8577

munakata@hcs.tsukuba.ac.jp

Abstract
The purpose of this study was to conduct an intervention of human relation skill training using genetic
temperament concept and to examine its effectiveness as a method for managing stress caused by humanrelations. The subjects were divided into two groups. One was the intervened group comprising 20 subjects
selected by snowball sampling, who agreed to participate in the study. The other was the non-intervened
group comprising 19 subjects matched respectively with those in the intervened group.
To the intervened group we conducted the one-off individual intervention centered on human relation skill
using genetic temperament concept for about two hours. Then, one month and three months after theintervention, the self-administered questionnaire surveys were carried out by mail on the matters includingchanges in human relations and stress caused by such human relations. Also to the non-intervened group thesurveys were carried out in the same manner by main one month and three months after the first survey.
When analyzing the collected data, subjects were restricted to only female members (intervened group: n=13,
non-intervened group: n=15). The result of the analysis revealed significant changes toward the decline in
subjective stress, and improvement in the score of human relation among those in the intervened group. It

36

suggested, therefore, that the intervention using genetic temperament concept was effective as a technique forhuman stress management.
Keywords. Genetic temperament concept; human relation skill; temperament coaching; stress management.

1. Introduction
Nearly a half of all Japanese lived in Japan are reportedly under constant stresses and strains in recent years1) 2).
According to the Comprehensive Survey on Living Conditions of People on Health and Welfare 20043), among
the causes of stresses and strains, the largest regardless of gender was one’s own health condition which
occupied 32.1% of the total multiple answers. This was followed by future income in one’s old age, which
occupied 28.1%. Human relations with own family and with non-own family occupied 13.2% and 17.7%,
respectively. It means that the human relations with family and non-family combined are one of the major
causes of stresses, occupying 30.9%. Many earlier studies also reported that a person’s stress and healthwere much affected by the relations with people close to one4) 5) 6). Support to human relations could be said tobe an effective means for managing stresses.
Human relations are considered to be a system to fulfill mutual expectations, and the relationship isaffected by how to understand the heterogeneity of the other persons. As H. H. Kelley and J. W. Thibaut7）
stated people on mutual interdependence are keenly interested in explaining each other’s behavior. Each ofthem wishes to know what the counterpart really likes because he/she wants to know what he/she can expectfrom his/her counterpart in future and how he/she can change his/her partner’s behavior. The question is if thepersonality of the counterpart is forecastable or not, because the most important social interaction arises if the37relationship is to be broadened in to the future7）. In other words, obtaining the information to forecast the taste
and behavior of the counterpart will be an effective means for adjusting the human relations.
It is said that man based on his/her own perception, understands the object persons, estimates their
future behavior and decides how to contact with them8). If so, the support to tighten the control of personalemotion, which affects the personal perception, and also enhances the ability to forecast is considered mostimportant for the man to become acclimatized to a social environment. We believe it is an important task inmodern stressful society to accommodate self-care support for the people not to depend solely on the support
from the specialists but to independently enhance their own stress management ability9).
When we look at our human relations in everyday life, we often taste the bitterness of dissatisfaction,
anxiety and sorrow because the object persons in most cases behave against our expectations. According toour knowledge of recent behavioral genetics, however, man’s behavioral traits in many cases look to begenetically regulated and thus there is an irrational aspect to our expectations to others as suggested byCloninger10）and Gray11）. Kijima, applying Cloninger’s theory, stated that “the biological factor of behavioral
traits might be applicable also to ‘Person-Person fit’ to which we often refer when we consider compatibility oftemperament among people”12).
Munakata advocates his original temperament coaching based on the knowledge obtained from hisaccumulated clinical studies13). He built up the theory that one can improve human relationship not by expecting
what seem unexpectable due to genetic factors on the counterpart but by rationally expecting only what seems
expectable, and he has actually achieved a measure of success in relieving stress caused by humanrelationship. It has not yet been proved, however, if his temperament coaching is effective for the long-term
38sustainability of stable human relationship. To the best of our knowledge no other studies on the measures toimprove stress caused by human relations similar to his have been reported worldwide. As the result of oursearch by PubMed as of July 2008, we hit 259 study reports and articles in overseas for the past 5 years with‘interpersonal stress management’ as the key words, while 142 with ‘human relation skill’, 4 with ‘human relation
skill’ and ‘stress management’ combined, and 12 with ‘human relation skill’ together with ‘intervention’. In thosereports and articles, however, the objects of the studies are victims of DV and mentally handicapped persons.
We found no such reports that referred to the methods and practices of stress management of human relations
for ordinary people and the studies on interventions to them.
The present study is intended as an intervention based on the theory of temperament coaching for the
management of stress caused by human relations to examine the follow-up survey after one month and threemonths, respectively, and to examine the effectiveness of stress management by this temperament coaching.

2. Method
1) Method of Survey
The prospective cohort study was adopted. Those who agreed to participate in the study were divided into twogroups, namely, the intervened group and the non-intervened group. The former consists of 20 persons (2men, 18 women, average age 37.8 ± 10.6) selected by snowball sampling. Next we requested individuals
who were matched in age and sex with members of the former groups (and consented to cooperate in the
study) as members of the non-intervened group. This non-intervened group consists of 19 persons (3 men, 16
women, average age 37.7 ± 12.1). At the starting point of the study everyone in both groups specified one
39

object person each as the counterpart from among his/her familiar acquaintances. The necessary conditions
for the specification were that the object person must be familiar to him/her; he/she had contacts with the object
person at least once a week; he/she intended to continue the relationship with the object person; and there is a
motivation for he/she to improve or restore the relationship with the object person. The signed self-entry
questionnaire surveys were sent to the intervened group by mail on matters that included changes in therelationship with the specified object person and subjective stress scale caused by such human relationship justbefore the intervention and then one month and three months each after the first survey. Also with eachindividual in the intervened group additionally semi-structured interview on his/her human relations was held
before and just after the intervention. To the members of the non-intervened group, the same surveys at thesame timing with those for the intervened group were also conducted. Outline of the proceedings of thesurvey for both groups is comparatively shown in Figure 1.

40

The intervened group

The non-intervened group

Pre-intervention : explanation on the study

The first questionnaire survey

The first questionnaire survey

Specification of the object

Specification of the object person for

person for human relations

human relations

The intervention : Interview
Check on temperament
Temperament coaching
Making the list of matters for
self-decision
Just after the intervention :The questionnaire survey
Interview
Follow-up survey after one month

Follow-up survey after one month

Follow-up survey after three months

Follow-up survey after three months

Fig. 1

Outline of survey

We were able to collect data from 15 participants in the intervened group (2 men and 13 women) four times, first
before the intervention, second just after the intervention, third 1 month after the intervention and finally 3 months
after the intervention.

As to the non-intervened group, we were able to collect from all the 18 participants (3men and 15 women) all the survey sheets. Both collection rates and valid response rates were 75% for theintervened group and 95% for the non-intervened group.

412) Method of intervention
The interventions, in the form of one-off interview with each participant in the intervened group for about twohours each, which centered on the temperament coaching to support understanding Munakata’s genetic
temperament concept were conducted between March and June 2006 by the author of this report who hadreceived training on temperament coaching. The genetic temperament theory, individually constructed by T.
Munakata, is the one to grasp personality/temperament as the hallmark of sensitivity and reaction against stimuli
from outside based on the fruit of recent studies on temperament in the field of behavioral genetics.
Personality/temperament is classified into three types as reported by Kretschmer, namely, cyclothemic, epileptic
and autistic. To define the strength of sensitivity and reaction of personality/temperament, added thereto are
immodithymia advocated by K. Shimoda, and novelty seeking temperament and harm avoidance temperamentby Cloninger. Munakata, in explaining the temperament coaching, makes the points of self-treatment andtreatment for others by type of temperament to effectively meet the traits of each genetic temperament and therequirement of each temperament. The temperament coaching trait of each temperament is grasped not only
as attitude and behavioral trait but also as something to urge understanding of other factors including biologicalones. Therefore, we urged all the participants in the intervened group to rationally adjust their expectations
from their respective human relations object persons through ascertaining the genetic temperament of their own
and of the said object persons with the information obtained from the temperament coaching and also throughunderstanding the differences of genetic emotional reactions. In other words, we urged them to realize the factthat it depended on the object person’s temperament if there was anything they could expect or not in thehuman relations and also to set up the behavioral targets in the human relations with the said object person so42

that they might enhance the reliability of their prospect on fulfilling their own needs. As to the details of the
expectations by type of temperament, please refer to the other literature17).

3) Intervention
In the interventions by temperament coaching, we first explained that the human relationship with those closer tothem was regarded as a system to fulfill mutual expectations and therefore that such relationship might beaffected by how to grasp the heterogeneity of the object person. And then, to presume the type oftemperament applicable to those of the cooperators themselves and of their respectively specified object
persons, the self-check list was made to identify genetic temperament. As the scales had not yet beenstandardized then, we regarded the type of temperament applicable to the cooperators themselves and their
specified object persons as the clue to our judgment, we left the final specification of the applicable type oftemperament to each cooperator’s own judgment, with our supplementary explanations on temperament whennecessary. The trait of human emotional reaction depends very much on individual genetic temperament.
Our human relations will be aggravated and our stress will be intensified if we, lacking in understanding of theheterogeneity and judging the conduct of the object person only to be corrected, keep our unilateral expectation.
We, having paid our attention to the above consideration, urged them to set the targets of necessary actions
including to make a distinction between what can be expected from the object person and what cannot be
expected for improving the relations or reducing the stress on the basis of mutual heterogeneous temperaments.
Finally they made a list of what must be done by themselves.

434) Consideration of ethical aspect
We explained to both intervened and non-intervened groups in writing and orally what the study was designed toachieve, received the agreement in writing from all the collaborators, and then conducted the survey. To thosein the non-intervened group who requested us to disclose the results of the survey including the list of genetic
temperaments for self-checking completed in the first survey, we sent private letter to each of them describing
the measures for self-treatment by type of temperament and our advice on human relations and enclosing
therewith printed material on genetic temperament concept utilized in the temperament coaching.

5) Composition of questionnaire survey sheet
The questionnaire survey sheet was composed as shown below:① Attributes of the study cooperator: full name, age, sex, occupation and mail address② Attributes of the object person of human relationship: age, sex, occupation, and relationship③ Scale of human relations: A new scale was produced solely for this study with partial amendment andsupplementation to the scale of human relations developed by Munakata. Each cooperator was
requested to show the current relations with the object person specified by the very cooperator putting
a circle on the line. Seven alternatives were given such as “I want to be with the object person all thetime”, “It makes me happy to talk with the object person”, “I am glad to see the object person”, “Itmakes no difference in either way,” “I want to look away from his/her face when I see the object
person”, “It makes me unpleasant to talk with the object person” and “I want the object person to clear
out of my sight”. A score from 6 to 0 was given to each alternative. The higher the score, the better
44

the human relations with the object person.
According to our instruction, the cooperator specified the object as the counterpart of the humanrelations under the following conditions: (1) The specified object person must be one of the otherpersons very much closer to the cooperator including his/her family members. (2) The cooperator
has contact with the specified object person at least once a week. (3) The cooperator has anintention to continue the relationship with the specified object person. (4) The cooperator has amotivation to improve or restore the relationship with the specified object person. The above
requirements were accepted and we were able to measure the scale.
④ Subjective stress scale: We asked every cooperator to show the scale of their subjective stress causedby the human relations with specified object person on a straight line of between 0% and 100%, inwhich 0% represented non-stressful state.
⑤ Self-esteem scale: We adopted the concept advocated by M. Rosenberg, 1965 (tr. T. Munakata,1987)20)21). Positive self-evaluation is measured by responses to the 10-item questionnaire. Each
item had three-response choices. The higher the score between 0 and 10, the better self-image therespondent had.
⑥ The list of self-check on genetic temperament: The list contains the scales to measure the degree ofintensity of six types of temperament such as cyclothymia, epileptoid, autistic temperament,
immodithymia, anxiety temperament and novelty seeking temperament, which were based on
Munakata’s genetic temperament concept and were developed through our clinical experiences.
Total 30 questions were prepared with 5 per type of temperament22) 23).
45

⑦ Questions on human relations and temperament concept requiring free descriptive answer: To grasp
the changes in the relations with the specified object, responses were obtained in free description
under the heads including ‘your current relations with the specified object’, ‘your attitude toward thespecified object’ and ‘the changes in your own behavior’. Other heads on understanding the conceptof temperature and its application were added for the non-intervened group and also responses wereobtained from them in free description formula.

3.

Analysis

In the obtained data the ratio of men to women was unbalanced for each group; 2 men and 13 women for theintervened group while 3 men and 15 women for the non-intervened group. According to some earlier
studies24) 25), the interactive effects by differences between the sexes should be taken into consideration, but itgets too much complicated to analyze them. Thus in this study we limited the object of the analysis only towomen (13 women with average age of 36.2 ± 12.02 for the intervened group, while 15 women with averageage of 39.1 ± 11.47 for the non-intervened group).
To analyze the obtained data we used the SPSS version 11.0 for Windows. Wilcoxon Signed-Rank
Test was conducted for comparing the data from the first and second surveys of the intervened group. Also toevaluate the sustainability of effects of intervention at each three points of time, the first survey, one month andthree months each after the intervention, we conducted the Friedman test for each group. In addition to theabove, for multiple comparison we used the comparative diagram of object figures and examined the scalescores at each three surveys using Wilcoxon Signed-Rank Test with corrected p-value. Also, to compare the46intervened group with non-intervened group at each three points of time, we adopted the Mann-Whitney U test.

4. Results
1) Changes in the scale scores for each group
After the interventions conducted with the temperament coaching, we compared the scale scores of theintervened group between the two points of time; the first survey and just after the intervention. As a result, thesubjective stress scale showed significant declines (ｐ=.004) and the human relations scale scores showedsignificant increases (ｐ=.011), Table 1.

Table 1Comparison of scale scores at the pre-intervention point and those just after theintervention
at the point ofjust after the

pre-intervention

intervention

Me(Q)

Me(Q)

degree of subjective stress70 (22.5)

50 (13.8)

.004

Human

3.0 (0.9)

4.0 (1.0).011

relationsscale

ｐ-valuescoresWilcoxon signed-rank test （n = 13）

Subjective stress scale scores for the intervened group showed significant differences in both comparisons;between pre-intervention and one month after (ｐ=.036), and also between pre-intervention and three months
after (ｐ=.036) (Fig. 2).

47

Scores
100
90
80
70

The
intervened
group(n=13)* The intervened group* The intervened group

The nonintervened
group(n=15)

70

60
50

50
40

40
30
20

40

30
n.s. The non-intervened group† The non-intervened group100preintervention

3 months
1 month
after theafter theintervention intervention

Friedman test ： The non-intervened group P=.080, The intervened group P=.015
Mann-Whitney U test ： pre-intervention ｐ=.108, 1 month after the intervention ｐ=.618, 3 months after the intervention ｐ=.467*: ｐ<.05 † : ｐ<.１0
n.s. : nonsignificant

Fig. 2 Changes in the degree of subjective stress

Human relations scale scores for the intervened group showed just a limited upward tendency in the comparison
between pre-intervention and one month after (ｐ=.052), but the comparison between pre-intervention andthree months after showed a significant rise (ｐ=.0014) (Fig. 3).

Scores
6
5

5
3.5

4
3

3

4

3.3

2
1

The intervened
group(n=13)
The non-intervened
group(n=15)0pre-intervention 1 month after the 3 months after
intervention
the intervention

Fig. 3 Changes in human relations scale scores
48

While self-esteem scale scores for the intervened group showed a significant result in the Friedman Test, there
was little noticeable difference in the comparisons neither between pre-intervention and one month after nor
between pre-intervention and three months after (Fig. 4).

Scores
10
8

8
6

7

4

4

8
6

5

2
0
preintervention

1 month
3 months
after theafter theintervention intervention

The intervened
group(n=13)
The nonintervened
group(n=15)

Mann-Whitney U test： pre-intervention ｐ =.001, 1 month after the intervention ｐ =.002, 3 months after theintervention ｐ =.003

Fig. 4 Changes in self-esteem scale scores

As to the non-intervened group, the subjective stress scale scores showed no significant difference in thecomparison between the point of first survey and one month after, and just a limited declining tendency in thecomparison between the point of first survey and three months thereafter (ｐ=.060). Scores of both humanrelations scale and self-esteem scale revealed significant differences in the comparisons neither between thefirst survey and one month thereafter nor between the first survey and three months thereafter (Figs. 2, 3, and
49

4).

2) Comparisons of scale scores among each point of time between the intervened group and thenon-intervened group
At the first survey, the comparisons of subjective stress scale scores between the intervened group and thenon-intervened group showed no significant differences, but human relations scale scores for the
non-intervened group was significantly higher than those for the non-intervened group (ｐ=.041). At eachpoint of one month and three months after the first survey, no significant difference was shown between the twogroups (Fig. 3). On the other hand, the comparisons of self-esteem scale scores showed significantly lower
result in the intervened group than in the non-intervened group at every three points of time (before theintervention : ｐ=.001, one month after intervention : ｐ=.002, and three months after intervention:ｐ=.003)(Fig. 4).

3) Major types of temperament of the cooperators in the intervened group and their human relations
object persons
Shown in the Table 2 are the major types of temperament, which the cooperators of the study judged applicableto those of their own and of their object persons through the course of the intervention using temperamentcoaching. It was revealed that according to the cooperators’ recognition

the other persons that theyspecified as their object persons with whom they felt motivated for improving or restoring human relations had
different types of temperament from their own.
50

Table 2
Major types of temperament of survey cooperators in the intervened group and of those who wereselected as object persons for human relations
No.

Major types of temperament of

Sex and major types of temperament of humansurvey cooperators in therelations object person

intervened group1

Immodithymic temperament

male

Cyclothemic temperament

femaleAutistic temperament

femaleImmodithymic temperament

femaleAutistic temperament

femaleCyclothemic temperament

Anxious temperament
2

Cyclothemic temperament
Novelty seeking temperament

3

Cyclothemic temperament
Anxious temperament

4

Immodithymic temperament
Anxious temperament

5

Autistic temperament

Immodithymic temperament
6

Autistic temperament

femaleAnxious temperament

femaleEpileptic temperament

Anxious temperament
7

Anxious temperament
Immodithymic temperament

Immodithymic temperament

Autistic temperament

Anxious temperament

Cyclothemic temperament
8

Immodithymic temperament

male

Anxious temperament

Autistic temperament
9

Cyclothemic temperament

Cyclothemic temperament

femaleImmodithymic temperament

male

Noveltyseeking temperament

Immodithymic temperament
Anxious temperament
10

Autistic temperament

Cyclothemic temperament

Anxious temperament

51

Immodithymic temperament
11

Autistic temperament

femaleCyclothemic temperament

12

Cyclothemic temperament

male

Epileptic temperament
Novelty seeking temperament

Novelty seeking temperament
13

Autistic temperament

femaleCyclothemic temperament
Novelty seeking temperament

Anxious temperament

5. Discussion
According to Munakata’s stress function model, cognitive stress management means, under the circumstancesin which things in life do not go as one wants them to, to clarify one’s own demand, to deepen the
self-confidence with predictability for fulfilling it and then to obtain the support from others. In our study, theeffectiveness of the intervention as a technique for managing the stress caused by human relations wasappraised from the following three operative viewpoints; ‘stress cognition’, ‘human relationship cognition’ and‘self cognition’. We examined how the three variables of demand, predictability and support in the stressfunction model were controlled watching the changes in each scale scores.

1) Effects on stress cognition
Subjective stress of the intervened group showed a significant decline from the point of pre-intervention to thatjust after the intervention. It also showed a significant decline both at the point of one month and three months
after the intervention from the point of pre-intervention. On the other hand, subjective stress scale scores of
the non-intervened group showed no significant changes at any three points of time of the first survey, one52month and three months each thereafter. Thus observed was the effect of intervention to relieve subjective
stress in the intervened group.

Judging from the fact that, by the one-off intervention using the temperament coaching, subjective stressshowed a significant decline with its continuous effect for three months thereafter, it is believed that thecooperators promoted in the first place their understanding on the temperament of their human relations object
persons, and then progressively enhanced their predictability concerning other persons’ attitude and behavior
necessary to adjust their human relations. In addition, we assumed that the cooperators were given an
opportunity to reconsider how to behave and cope with others on the understanding of temperament of theirown and their object persons, which had been obtained from drawing up the list of matters to be decided bythemselves as a behavioral target after the intervention, and also that they were able to promote the fulfillment ofdemands by way of switching their one-sided expectations and demands of the others over to those ofpracticable nature. We heard from many of the cooperators in the intervened group that the temperamentcoaching seemed well applicable also to the human relations with those other than the object persons.
Actually we confirmed the effects of promoted supportive recognition in some cases.

As shown in Table 2, it became clear that the types of temperament of human relations object persons specified
by the intervened group were recognized different from those of the cooperators’ own judgment. However, it isdifficult to verify if the temperament of the object persons was actually matched with the cooperators’ own
judgment. On the other hand, it seems also true that one is apt to understand the others, predict their future53

behavior and decide how to cope with them based on their own cognition on them27). Thus, it seems moreprobable that the human relationship is affected more by observer’s own subjective viewpoint than the object’s
real person. Accordingly, the scale of subjective stress caused by human relations is also expectedly affectedby how to recognize the other heterogeneous person, and it is believed that to look at themselves and the others
objectively from the viewpoint of genetic temperament concept obtained through the intervention effectively
helped them establish the basis to accept heterogeneity of the other persons.

2) Effects on human relations cognition
As a result of adjustment, the human relations scale scores at the point just after the intervention showed asignificant improvement from the point of pre-intervention. The human relations scale scores at the point of
one month after the intervention showed a somewhat improving tendency from the point of pre-intervention.
Also, the human relations scale scores at the point of three months after the intervention showed a significant
improvement from the point of pre-intervention. Thus the effects of the intervention were quite obvious. In
case of the non-intervened group, however, significant changes were not confirmed at any three points of time,
one month and three months after the first survey.

Cognition on personal relationship, the perception of the other persons, is said to have different feature from thatof matters28). In the cognition on personal relationship, judgment leads to not only sensory information directly
stimulated by the present objects but also a lot of various information covering a wide area in terms of time andspace such as other person’s past behavior, rumors circulated by outsiders and even internal characteristic and54

psychological process of the person who is not necessarily responsive to external stimuli. In such a process
as above, the content of recognition depends much upon subjective factors of the very cognitive person.
Although the object person’s attitude and behavior remain unchanged, their meaning may change withavailability of different type of recognition on human relations through understanding the temperature concept.

The human relation scale score does not expresses objective relationship but subjective personal feelings
towards object persons. Feeling is the fundamental factor for making the attitude as it has been indicatedsince way back that by changing a feeling, a factor for making the attitude, the cognition, another factor, is to bechanged29). Also, according to Munakata30), feeling is defined as “an indicator of one’s appreciation forthepredictability and the result of his/her demand for being fulfilled or not.” From the knowledge as introduced
above, the human relation scale scores may be considered to express the degree of one’s expectations anddemands to the object person and of their fulfillment as well. When one’s high expectation to the object person
is fulfilled, one finds satisfaction and holds the cognition of favorable relations. When one’s expectation to theobject person, though being so high, is not fulfilled, one harbors dissatisfaction and hatred and holds the
cognition of worsened relations. Human relations scale scores in the intervened group at the point threemonths after the intervention were significantly improved compared with that of pre-intervention. Thisobservation led us to the understanding that the attainment of the plan to make personal feelings controllable
through changes in the degree of fulfilling the demands was a factor in the improvement of cognition on personal
relations. There was a question requiring a written answer, “what does it mean for you personally to know theconcept of temperament?” in the survey conducted three months after the intervention. The followings are55some major examples of descriptive answers obtained from the intervened group; “I think it enables me toreview myself. By so doing I think I can aim at better communication with the people who have something to
do with myself.” “It is related to knowing the feeling and essential personality of the object person.” “It was
believed necessary to know the object person and myself. “If I had not known the concept of temperament, I
wouldn’t have come in contact with those who I had difficulty to understand each other from the very beginning.”
From these answers it was assumed that raising the motivation to improve the relationship through cultivating abetter understanding on oneself and the object person was a reason for the personal relations to be improved.

3) Effects on self cognition
Self-esteem scale score showed a significant result by Friedman test but showed a significant difference in thecomparisons neither between pre-intervention point and the point after one month nor between pre-intervention
point and the point after three months. Small number of participants in the intervened group is considered tohave affected such consequences. So reexamination seems necessary with the increased number of data.

There are lots of factors that may influence the self-recognition. The image of past memory in particular
controls the present self-image and the behavior as an output31). There is a possibility therefore, that the effectof one-off intervention by temperament coaching, which exerts influence upon present recognition, had adifficulty to remarkably improve the self-image although it makes a contribution to the adjustment of environment
focused on human relations. It is believed to be meaningful for positive self-recognition to have a prospect for
fulfilling the demand single-handed with the aid of the temperament coaching by adjusting own expectations in56

accordance with the object person’s temperament whatever it may be.

As a result, the self-esteem of the intervened group was lower than that of the non-intervened group at every
three points of the first survey, one month and three months thereafter. It was possibly caused by thedifference of collective trait between the two groups, but it is hard to examine it at present. According toHashimoto et al32), by changing the image of important other persons including the parents from negative one topositive, the root feelings connected to the present problem such as fear and danger are relieved, which leads tothe positive change in self-image. We have a fair idea that the intervened group, having from the outset
sensed intensely negative personal feeling against closely related other persons, had fewer chances to change
self-esteem to the positive one than the non-intervened group and that it was one of the reasons for the lower
self-esteem of the intervened group.

6. Conclusion
In this study we conducted an intervention using temperament coaching for the management of stress causedby human relations and examined its effectiveness one month and three months each thereafter. The
subjective stress in human relations declined and the scores of human relations scale continuously improved.
In other words, the intervention demonstrated its effectiveness for the management of stress caused by humanrelations changing the subject’s own recognition of the human relations to positive one. Thus, the intervention
using temperament coaching suggested certain effectiveness as a technique for managing stress caused byhuman relations.
57

We believe it quite meaningful for setting up a supporting system to cope with stress by individual self-care thatan intervention working upon cognition brought about good results. Future study seems required to further
enhance the effects of the intervention as a realistic and concrete technique for managing stress caused byhuman relations, which may meet simultaneously both the requirements to reduce stress connected with humanrelations, and to make the most of human relations as a resource needed for coping with a lot of stress.

7. Limitations of the study
On dividing the cooperators with this study we first selected the subjects for the intervened group and then we
selected the subjects for the non-intervened group who were matched respectively with those of the intervened
group in terms of age and sex by individually requesting for their cooperation. Accordingly, there was mostprobably a bias against the degree of their interests in the study and of their motivation to improve therelationship with the object persons between the two groups. As to the way to set up the intervened group andthe non-intervened group, therefore, it should be noted as a future task to figure out proper random sampling inview of homogeneity between the groups.

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62

Shift in Frequency of Voice Accompanied with Emotional Change in a Cancer Patient
Kei-Ichiro Kobayashi* and Tsunetsugu Munakata**(SAT Therapy Project, University of Tsukuba)“Vivid Life” Counseling Room, Tokyo*
Department of Human Care Science, University of Tsukuba, Tsukuba**
Correspondence: Kei-Ichiro Kobayashi“Vivid Life” Counseling Room, 3-38-10 Miyoshi-Cho, Fuchu-City, Tokyo, 183-0045 Japan
Tel/Fax: 042-361-5363. E-mail: k.-i.kob@jasmine.ocn.ne.jp

Abstract
The shift in the frequency of voice of a breast cancer patient through SAT imagery therapy was studied with
FFT-analysis. The frequency of “AH” in a Japanese word “OKAHSAN” (or “mother” in English) remarkably
decreased from 293-312Hz to 137-185Hz with a change of imagery of her parents to the ideal ones. However,in the therapy where she strongly suppressed her negative emotion with fear of death, a disagreement between
verbal (the content of talk) and nonverbal (frequency) was observed. These results show that (1) the frequency
of AH generally decreases with the improvement of the emotion in the client, (2) the frequency shows anirregular behavior with suppressed subconscious emotion. Therefore, it is found out for the first time that thefrequency of “AH” in the Japanese word “OKAHSAN” can be used as a scale of human emotion.

Key Words. SAT imagery therapy; cancer; frequency; voice; emotion; FFT-analysis

63

1. Introduction
Information is sent and received in the form of wave which is accompanied with frequency such as light, sound,and electric signal. In the case of information concerning human emotion, vocal expression, facial expression
and behavioral expression are very important factors(1). In counseling, vocal conversation is the main medium ofinteraction between client and counselor. A counselor instinctively accepts a lot of emotional information from thevocal expression of a client. Therefore, it is expected that by analyzing the voice of clients we can obtain a clue
to solve human emotion scientifically from a new point of view.
By applying SAT imagery therapy to many cancer patients for several years, not only psychological scales
but also physiological data, such as immune function and expression of tumor-suppression genes, have been
improved (2,3,4). Among various tumor-suppression genes, p53 and RB are reported to be very important toprevent and diminish cancer(5). This indicates that resolving the relationship between mental situation andphysiological situation evaluated as the expression of tumor-suppression genes are very important to reduce thenumber of people who die of cancer.
Hori et al. studied the expression of genes by analyzing the crying of rat with FFT-analysis. Tickled rat
gave a peculiar crying with a unique component frequency of 50kHz in the ultrasonic region. In the brain ofticked rat, expression of genes was confirmed(6). From this point of view, we started researching the change of
vocal expression of clients whose physiological data including tumor-suppression genes have been improved
prominently through a series of SAT imagery therapies. In our daily life, we speak relatively higher interval in a
nervous feeling, and lower interval in a relaxed feeling. Therefore, as the first step, we noticed the frequency of64voice. Consequently, we have detected a very characteristic behavior of vocal frequency, and as a result, foundout that vocal frequency can be used as a scale of not only unconscious emotion but also that of subconscious
emotion.

2. Experimental
2-1. Application of SAT Imagery Therapy to Cancer Patient
After explanation of scientific grounds of SAT imagery therapy to cancer patients and obtaining their writtenconsent, we started the therapy. We took blood samples to evaluate the immune function and the expression of
4 tumor-suppressor genes; p53, RB, BRCA2, RUNX3. Details of the procedure have been reported in aprevious paper (3).

2-2. Personal Background and Medical History of the Patient
Patient in this study was a 46-years-old woman. Her mother was very emotional and had a tendency ofcontrolling her and her elder sister. Left breast cancer was recognized at the end of July 2001. The main subjectof this patient throughout SAT imagery therapy was a conflict with her mother and sister. Her detailed profiles
have been reported in the previous issue(3,4).
After three to four times of therapy, her psychological scales had been improved and kept this condition sincethen. Her immunity and the expression of tumor-suppressor genes showed a gradual improvement, and the final
stage of her 26 times of SAT therapies satisfactory data were obtained continuously(3,4).

65

2-3. Analysis of the Frequency of VoiceThe frequency of digitally recorded human voice was analyzed using Ono-Sokki DSO221 FFT-software. In
this study, Japanese words “OKAHSAN” and “OTOHSAN” were adopted for “mother” and “father” (in English),respectively. In these words, the long vowels “AH” and “OH” were chosen as the object of FFT analysis, as
underlined in Roman alphabetical expression above. The reason is (1) long vowel is adequate for the accuracyof analyzing position, (2) the same vowel in the same word should be analyzed because we pronounce thesame vowel in another words in different frequencies even in the same mental situation, (3) frequently spoken
words in the counseling are desirable to get plenty of data, (4) we must choose any object word which reflects
the human emotion with high sensitivity. Between these two words, “OKAHSAN” (mother) was used mainly and“OTOHSAN” (father) was used complementally.
At first, the voice of a counselor (a late 50’s man) was analyzed in order to demonstrate that the frequency ofhuman voice can be used as an index of human emotion. In the case of the counselor, three types of
expressions were picked up; (1) strongly affectionate and soulful situation when he was telling the “magic soulful
words” to the client, (2) fairly emotionless situation when he asked real or traumatic images to her, (3) slightly
affectionate situation where he repeated the ideal and desirable images of her. This was recorded through a
psychic counseling to a client without cancer using rebirth and rebearing imagery technique.
In the case of cancer patient, FTT analysis was carried out only for “AH” in “OKAHSAN” in the 1st , 2nd , 4th
and the 25th sessions. Situations when “OKAHSAN” was pronounced could be separated into two cases. The
first case is that when the client pronounced “OKAHSAN” with positive expression of her mother, and thesecond case is with negative expression. In this case, only the word “OKAHSAN” was analyzed because this66

word was spoken more frequently than “OTOHSAN”.

2-4. Rebirth and Rebearing Imagery Therapy
In Rebirth and Rebearing Imagery Therapy, imagery of parents, grandparents and great-grandparents arechanged into ideal ones for the client. At first, actual traumatic images are reminded by Structured
Association Technique, then on the ground of these images, ideal images are set. In the course of counseling,counselor asks client about the situation and personality of her parents, and the client answers the real and ideal
images of them. Therefore, in this part of the session, both counselor and client said the word “OKAHSAN” and“OTOHSAN” many times.
In this stage, these two words were pronounced by the counselor in two types of tone. The first type is thosewhen the counselor asks her the real image of parents without emotion, the second type is those when herepeats the ideal image of her parents. In this second situation, since the counselor conceives the ideal image ofclient, tone of “OKAHSAN” and “OTOHSAN” changed to somewhat emotional ones.
After this, the counselor talks to her the “magic soulful words”. As is shown below, in the “magic soulful
words”, counselor says the words “OKAHSAN” and “OTOHSAN” repeatedly.

2-5. “Magic soulful words”
To the clients in ideal in-womb images, the counselor tells soulful and affectionate words. At this point, since
the counselor is holding his/her most loving person such as his/her children, the voice of the counselor naturally
changed into strongly soulful and affectionate tone. “Magic soulful words” are as below.
67

(1)

Father and mother are delighted to be blessed with you, and love you very much.

(2)

Father and mother love you whatever you are, we are impatient for you to bear safely.

(3)

If you might have any trouble, be sure to tell father and mother.

(4)

Father and mother will help you with all our might.

(5)

Live in such a way that you will be grateful.

(6)

Father and mother will be most delightful to feel that you live satisfyingly.

3. Results
3-1. Voice of counselor
FTT analysis was carried out for three types of mental situation: (1) strongly affectionate and soulfulsituation, (2) fairly emotionless situation, (3) slightly affectionate situation.
The result of analysis for both “OKAHSAN” and “OTOHSAN” are shown in figures 1, 2. When thecounselor said those words very soulfully telling magic soulful words, frequency of long vowel “AH” and “OH”
was in the range of 100~120Hz. On the other hand, when he said them in fairly emotionless situation, frequency
was in the range of 150~250Hz. In addition, in slightly affectionate situation repeating the ideal images,
frequency was in the range of 120~150Hz; the middle range of two situations mentioned above. Therefore, as aresult, frequency of long vowel “AH” and “OH” in “OKAHSAN” and “OTOHSAN” decreased from the range of150~250Hz to that of 100~120Hz, with increasing soulfulness in the mental situation of the counselor. Thisshows that We are able to use the frequency of “AH” and “OH” in these two words as a scale of subconscious
emotion.
68frequency of "AH"(Hz)250
OKAHSAN(mother)200

magic soulful
words（affectionate
expression）

150

repeating ideal image（slightly affectionate
expression）
questioning（emotionless expression）

100
Vocal expression
Figure1. Shift of frequency of "AH" in "OKAHSAN" withthe change of expression (male counselor)

frequency of "OH"(Hz)250
OTOHSAN(father)200

repeatingideal image（slightly affectionate
expression）

magic soulful
words（affectionate
expression）

150

questioning（emotionless expression）

100
Vocal expression
Figure2. Shift of frequency of "OH" in "OTOHSAN" withthe change of expression (male counselor)

3-2. Voice of cancer patient
In the 1st session, remarkable shift was observed in the frequency of “AH” in “OKAHSAN”. Since this is thefirst session, she told the impression of her mother to us frankly. She said “My mother scolded me severely infront of my friend” and ”This mother is incredible.” In these negative expression, as shown in figure 3, frequency
69

of “AH” was as large as 293-312Hz. On the contrary, having desirable image of her grandparents andgreat-grandparents through the first session, frequency decreased to 137-185Hz; about 1/2 of that of negative
expression. From the viewpoint of musical interval, the effect of ideal image is as wide as one octave. At thisstage in an ideal in-womb image, she expressed her mother like this, “An affectionate mother is ideal”, “WhenI am born, mother welcome me”.

vocal frequency (Hz)

350
300

1st se ssion

2 nd se ssio nnegative expression

250

2 5 thacceptingmother200
150

positive expression

100
Vocal expression
Figure3. Shift of frequency of "AH" in "OKAHSAN"
with the change of expression (female patient)

vocal frequency (Hz)350

positivecontent

positivecontent

300
4t h session

250
200
150

suppr essed fea r ofdea t h by incr ementof t umor ma r ker

negativecontent

100
Vocal expression
Figur e4. Disa gr eement bet ween v erba l (cont ent )a nd nonv er ba l (fr equency ) obser v ed in "AH"in "OK AHSAN" (fema le pa t ient)70

In the 2nd session, a similar change in frequency was observed as in the 1st session (Fig. 3). In the 4th
session, apparently incomprehensible results were obtained. In figure 4, some large frequency data wereobserved in the positive expression of “OKAHSAN”, and some small frequency data were obtained in thenegative expression. This was reversed behavior of the frequency to those observed in the 1st and the 2nd
session. When she said “ Mother is in a severe atmosphere by being accused ” and “ It makes no difference
even if we return to Japan without mother at the end of the world war ”, observed frequency was 162-167Hz; inthe range of small frequency. On the contrary, when she said “Mother is expecting baby in a relaxed feeling ” ,“Affectionate mother” and “I feel mother is satisfied and happy” frequency was 331-350Hz; in the range of large
frequency. There exists a disagreement between verbal (the content of talk) and nonverbal (frequency). Thisdisagreement is the characteristic of the 4th session.
The 4th session was done under strongly suppressed mental situation. At the end of every session, blood
sample was taken in order to check the immunitive force, such as the ratio of lymphocytes and neutrophils, andtumor markers. These data were told to the client at the beginning of the next session. As shown in figure 5, atthe end of the 3rd session the data of BCA225, a kind of tumor marker for breast cancer, made a sudden
increase to 201U/ml which is higher than the standard value (160 U/ml). When the client was told this increaseat the beginning of the 4th session, she perceived this as the reoccurrence of cancer with a fear of death. On theother hand, the ratio of lymphocytes and neutrophils at the end of the 3rd session, a scale of the balance
between sympathetic nerve and parasympathetic nerve are in their standard range. On the contrary, at the endof 4th session, BCA225 decreased to the standard range and the ratio of lymphocytes and neutrophils became
worse, suggesting she had a heavy stress to know the increase in BCA225. Her strong fear was not expressed71

in the 4th session, but expressed at the 5th session after being told of the decrease of BCA225. She said “I’mvery glad to hear that. I was so shocked to know the increase in BCA225 that I couldn’t speak my fear in the lastsession. Although I had told you I became positive through SAT therapy, I couldn’t eat meal for a few days after
the last session.”ratio of lymphocyte &neutrophil（％）

after 3rd
sessionneutrophil
lymphocyte
BCA225

70

50

200
180
160

30

140
after 4th session

120

03

pr

e
1
af st
te
r
af 1st
te
r2
af nd
te
r
af 3rd
te
r4
af th
te
r5
af th
te
r6
af th
te
r7
af th
te
r8
af th
te
r
af 9th
te
r1
0t
h

10

BCA225（tumor marker U/ml）

90

Serial number of therapy
Figure5. Change of the ratio of lymphocyte & neutrophilby the increment of BCA225

In the 25th session, she said “OKAHSAN” only once. She told us the recent relationship between her mother.
She said, she talked to her mother “Mother, you appear to me, even if you fawn on others you would not
become happy”. Although the content of this conversation is rather negative, analyzed frequency was 183Hz; inthe range of low frequency. She continued “By setting estrangement from my mother, she changed not to ask
me what would I do today. She understood the reason. Consequently, relationship between my elder sister was
improved. I feel the prospects for the future are very good.” She told about her mother very frankly. Her talk held72both positive and negative contents. But as a whole, she accepted her mother as she was. Since the main
subject of this patient is a conflict with her mother and sister, this small frequency confirmed that her therapy
could be concluded.

4. Discussion and Conclusion
FTT-analysis applied to the voice of male counselor shows that the frequency of “AH” and “OH” in“OKAHSAN” and “OTOHSAN” decreased from the range of 150~250Hz to that of 100~120Hz with increasing
soulfulness in the mental situation of the counselor. This shows that we are able to use the frequency of “AH”
and “OH” in these two words as a scale of unconscious emotion.
Also in the case of female cancer patient, the frequency of “AH” and “OH” in “OKAHSAN” and“OTOHSAN” decreased through the SAT imagery therapy in each session. The most remarkable decrease wasobserved in the 1st session, where the frequency of initial negative expression spoken in 293-312Hz decreasedby half to 137-185Hz in the positive expression. In the 25th session, although she spoke about her motherincluding both positive and negative aspects, the frequency or “AH” in “OKAHSAN” was pronounced at 183Hz;
the frequency range of positive expression. Very peculiar reversed behavior of the frequency was observed in
4th session. This behavior agrees with the strongly suppressed extraordinary mental situation of the client,suggesting a disagreement between verbal expression (the content of talking) and nonverbal one (frequency).
Taking all these results into consideration, it can be concluded that the frequency of “AH” and “OH” in“OKAHSAN” and “OTOHSAN” can be used as a scale of not only unconscious emotion, but also subconscious
emotion of human being with high sensitivity.
73

Human voice is pronounced by the vibration of the vocal cords. The frequency of string is expressed by
the next formula.
ν＝（ｊ/2ｌ）（Ｔ/σ）1/2（ｊ＝1,2,3・・・）(ν: frequency, l: length, j: 1,2,3・・・(integer), T: force, σ: linear density)
According to this formula, when a person get nervous, he or she unconsciously strains the muscle in the vocal
cord more strongly, consequently the frequency of the voice increases. This qualitatively agrees with theobserved phenomena.

References
1)

Munakata, T.: SAT Health Psychotherapy Supports our Revolutionary of Way of Life, Journal of HealthCounseling, 14:1-10, 2008.

2)

Munakata, T.: Building SAT Therapy to Activate Anti-Cancer Genes and Immunologic Function forCancer Treatment. International Journal of Structured Association Technique, Electronic Journal of Social
Skill, Counseling and Imagery Therapy, 1: 3-35, 2007.

3)

Kobayashi, K.-I., Hashimoto, S., Hayashi, T., Sakamoto, S., Hori, M., Obitsu, R., Murakami, K., & Munakata,
T.: Treatment of Patients With Cancer for Stressful Emotion Transmitted from Ancestry by Using Genetic
and Immunologic Data as Barometers. International Journal of Structured Association Technique,Electronic Journal of Social Skill, Counseling and Imagery Therapy, 1: 36-58, 2007.

4)

Munakata, T. and Kobayashi, K.-I.: SAT Imagery Therapy for Cancer, Shunju-sha, Tokyo, 44-68, 2007.

5)

Morgenbesser, S.D., Williams, B.O., Jacks, T., & DePinho, R.A. p53-dependent apoptosis produced by74

Rb-deficiency in the developing mouse lens. Nature 371(1): 72-74, 1994
6)

Hori, M., Urayama, O., Hayashi, T., Nakagawa, Y., Sakamoto, S., & Murakami, K.:
Communication.

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