Backed Into a Corner: A Qualitative Case Study of a Woman with Chronic Pain
International Symposium on Music and Medicine
Aim of Investigation. The purpose of this qualitative case study was to understand the experiences of a woman with chronic back pain resulting from failed back surgery as she utilized music therapy to assist her in weaning herself off of opiates and other medications. This individual had been told by her physicians that medication was her only hope for being able to cope with the debilitating pain she continued to experience after having had back surgery.
She, however, had become quite depressed as the large number of medications she had been prescribed left her unable to function at her job or to do usual things she enjoyed in her daily life because of their cognitive effects and sedation. This study sought to understand how music therapy could play a role in making meaning of the experience of chronic pain, and assisting in shifting the perception of pain to allow use of fewer pharmaceuticals.
Method. The study utilized individual music therapy sessions with the client over one year’s time. Sessions were conducted primarily utilizing the Bonny Method of Guided Imagery & Music (BMGIM) as well as some modified GIM, and mandalas and improvisation as means of processing the imagery sessions. Transcripts of imagery sessions, transcripts of pre- and post-session processing, drawn mandalas, and shared portions of the client’s journaling from between sessions were used as multiple data sources in order to triangulate the data for increased trustworthiness. Additionally, multiple analyses and member checking were utilized to ensure credibility and dependability of the researcher’s interpretations, and a peer consultant served as a peer debriefer and as a source to confirm the evidence and its interpretation.
Written data was segmented and coded, and content which was considered devoid of relevant meaning was culled (e.g., images such as floating or walking without engagement in the image itself). Drawn mandalas were interpreted first by the client and secondly by the researcher according to MARI theory (as developed by Kellogg). The written form of these interpretations were also segmented and coded. Coded segments of a similar nature were grouped into categories and interpreted. As new data was gathered from sessions, the groupings were reanalyzed, and codes were added or changed as the evidence required. At each stage of reinterpretation, the client provided feedback about accuracy of the reinterpretations and any changes in coding. Likewise, the peer consultant gave feedback about the trustworthiness of the analysis at multiple points throughout the process.
Results. Several themes became apparent over time, particularly those of helplessness, shame, and punishment. The client’s imagery began to reveal connections between her perceptions of her physical pain, and emotional pain from events and situations in her past. They also began to reveal to her awareness the numerous ways in which her behavior in daily life mimicked or re-enacted these past situations and events, which kept the feelings, emotions, and thoughts patterns from the past active in her current experiences. The client was able to draw strong parallels between her descriptive language about her chronic pain, and the descriptive language she used about certain situations and relationships in her daily life. As she made these connections and began to develop some understanding of how unresolved issues from her past continued to play themselves out in her daily life, she was able to take some decisive action to change her current circumstances.
The client discontinued use of all opiate pain medications about four months into the therapy series chronicled in this study, and had stopped taking all but one anti-depressant medication by the end of the study period. At the same time, she identified a friendship which was toxic in that it re-enacted unhealthy situations from her past, and distanced herself from that individual. Of particular importance in her perception was her ability to say “no” to people, which empowered her and combated typical feelings of helplessness.
In the end, the client found that she had previously experienced the “weight” of her unresolved emotions to be “too much to bear.” In making meaning of her unresolved emotional pain, she found that the “weight” was lifted off of her, and this caused a significant shift in her perception of her physical pain in her daily life. The client not only felt significantly less depressed, but she began to do things that she had not done for more than eighteen month’s time, including working in her flower garden and taking her dog for walks.
music therapy, BMGIM, chronic pain, qualitative, case study
Music | Other Music
Nancy A. Jackson (2011).
Backed Into a Corner: A Qualitative Case Study of a Woman with Chronic Pain. Presented at International Symposium on Music and Medicine, Minneapolis, MN.