Dissertation - World Federation of Music Therapy

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in contrast to Burns’ study, the observed changes in depressed mood and total mood disturbance were not sustained through the 6-week follow-up. There were no significant changes in endocrine markers. The authors conclude that for clinical populations, a minimum of 10 sessions may be needed to effect sustained change in distressed mood. 2.4.4 BMGIM in palliative care As mentioned earlier, modifications of the BMGIM format is found very often in palliative/hospice care of cancer patients, and it is debatable whether or under which circumstances classical BMGIM is possible and appropriate with patients in palliative care. Bruscia (1994) worked with patients suffering from AIDS and identified the earlier mentioned five core images of gay men living with AIDS. This imagery documents how BMGIM enable patients faced with a life-threatening disease to express their emotions, fears and hopes, and to reconcile themselves with their life situation (see section 2.4.1). Erdonmez (1994) described a series of five BMGIM sessions with a 50-year-old woman with Motor Neurone Disease (MND). Her ability to engage music and imagery enabled her to face images of death and transition and experience profound spiritual growth. Washington (1990) investigated the effects of modified BMGIM on the reduction of anxiety levels in terminally ill cancer patients. Twelve subjects were used, all with a diagnosis of cancer considered untreatable and therefore terminal. Subjects ranged from fifty to eighty years of age and were referred by the social service division of an in-home hospice program affiliated with a large city hospital. The measurement tool used in this study was the State Scale of the State-Trait Anxiety Inventory (STAI), a forty-item inventory designed to measure degrees of state and trait anxiety in the general population. The STAI was administered before and after the music intervention. No statistically significant results were obtained, and only in limited cases were post-test scores slightly reduced from pre-test scores. The results may have been due to the size of the sample, the severity of illness or other unknown factors. 32
However, subjects’ verbal reports and responses to the intervention were favourable and suggested that the music intervention did promote increased relaxation and comfort and a reduction in feelings of anxiety and stress. Wylie and Blom (1986) described the music, relaxation procedure, guided imagery, and patient responses to imagery used with hospice patients. Two hospice patients were subjects in individual case studies. A variety of music was used with each subject, both preferred selections and unfamiliar music. Music and guided imagery were used to help facilitate pain control, and help patients reminisce about their lives. This procedure also provided the patients with opportunities to control some aspects of their life. They could be creative and temporarily feel safe and secure. Descriptions of how imagery and music were adapted to the needs of each patient are also presented. Marr (1999) reported how BMGIM was used as part of a music therapy program in both in-patient and home-based hospices for patients with a terminal illness. It was found that sessions using either standard BMGIM or an adapted variation were effective in assisting two patients in their personal and spiritual preparation for their final journey. Each patient received much in the way of personal insight and integration so that they could move forward without fear of what was to come. It is proposed and demonstrated that, under the right conditions, BMGIM can be a valid and effective therapy as part of a palliative care program. The paper includes a discussion of how to determine when BMGIM is appropriate and how to modify the process to be most effective with hospice patients, an issue raised by Martin (1993), who considered BMGIM contraindicated in palliative care because of the patients’ lack of strength. There seems to be no clear answer to the question whether standard BMGIM is an appropriate and useful method in palliative/hospice care. It may be more relevant to see a spectrum of options, going from BMGIM being inappropriate due to the physical weakness and/or the resistance of the patient, to BMGIM being appropriate and useful for patients in palliative care who have both the strength and motivation necessary for music psychotherapy. 33
Page 1: THE BONNY METHOD OF GUIDED IMAGERY
Page 4 and 5: Ph.D. student’ with me the last t
Page 6 and 7: vi 4. METHODOLOGY..................
Page 8 and 9: viii
Page 10 and 11: TABLE 8. 4 EVENT STRUCTURE ANALYSIS
Page 12 and 13: xii
Page 14 and 15: xiv
Page 16 and 17: xvi
Page 18 and 19: As you will see there are many comm
Page 20 and 21: The participants in this study use
Page 22 and 23: Music in medicine The terminology o
Page 24 and 25: Music in medicine vs. Music therapy
Page 26 and 27: more likely a reaction to a cancer
Page 28 and 29: melanoma Boesen (2002) reviewed the
Page 30 and 31: test showed that there was less ten
Page 32 and 33: More general overviews of how music
Page 34 and 35: Table 2. 1 Literature on BMGIM and
Page 36 and 37: Populations include non-clinical/he
Page 38 and 39: McKinney 1990 University students M
Page 40 and 41: Table 2.2 shows that most of the st
Page 42 and 43: Facilitating peak experience Provin
Page 44 and 45: express and work on their experienc
Page 46 and 47: 2) locus of control (inner mastery
Page 50 and 51: In Denmark two music therapists hav
Page 53 and 54: 3 Theoretical background 3.1 Introd
Page 55 and 56: metaphor influenced each other in o
Page 57 and 58: is closely related to the body and
Page 59 and 60: structures or patterns that “allo
Page 61 and 62: explaining a phenomenon with other
Page 63 and 64: Ricoeur agrees with Ernst Cassirer
Page 65 and 66: “It appears as though certain fun
Page 67 and 68: daily life myths and fairy tales ma
Page 69 and 70: extent that it is organized after t
Page 71 and 72: Table 3. 4 Three moments of mimesis
Page 73 and 74: Thus, symbols and metaphors are the
Page 75 and 76: 4. Psychotherapy as humane care - r
Page 77 and 78: I suggest the following working def
Page 79 and 80: The scale of Klein et al. was not u
Page 81 and 82: In a psychological perspective meta
Page 83 and 84: 3.5 Narratives in psychotherapy In
Page 85 and 86: second category (analogous to ‘in
Page 87 and 88: “There currently exist no consens
Page 89 and 90: Table 3. 7 Mimesis 1-3 in narrative
Page 91 and 92: 3.6.1 Music as analogy A paper by D
Page 93 and 94: Smeijsters has coined the double co
Page 95 and 96: Table 3. 8 Musical elements interpr
Page 97 and 98: function through its pre-existent s
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end, motion and rest, tension and r
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Lakoff and Johnson’s cognitive th
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crying, or symbolized as falling ch
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our analyses. For it is only by ope
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Based on his study Jungaberle formu
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and ending on dominant a - a new ro
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cross is inevitable, and the music
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is the instrumental Ground from Blo
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therapists. Open and attentive list
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closely related to basic human self
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less elegant dance. My dance is a b
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describes him or herself as ‘feel
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asket and then lie down, tell about
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Holocaust Shadow (Schulberg 1999),
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Craftsmen are working The foundatio
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series of actions and transformatio
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References to examples in the BMGIM
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“Sublime music tells in its own w
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4. Methodology Following on from ch
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trained in Aalborg is still indigen
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3) The study has its starting point
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material or intentional phenomenon,
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can also be applied in multiple met
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Table 4. 1 Basic information on the
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• The preliminary conversation (a
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One week before project start all p
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Participants score each item on a 4
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c) Audio recordings (mini-disc) of
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• Specification (1. Sensitizing c
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The imagery of the six participants
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5. Results of the quantitative inve
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The mean score of the group in depr
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Table 5. 2 Effect sizes measured at
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Figure 5. 5 QLQ-C30: Mean scores of
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These results are variable, and onl
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Statistical analysis of QLQ-C30 res
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Figure 5. 9 SOC Mean scores from th
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Figure 5. 11 SOC: Pre-test, post-te
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Results - inferential statistics an
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The results support hypothesis ten.
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generalised further, was evidently
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6. Results from the qualitative inv
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Potential of GIM in other phases of
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coding, where the categories are in
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PIJØ: It has been very hard for me
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how should it be, should there be m
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changing. Participants described ho
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IMPROVED UNDERSTANDING OF SELF (NEW
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elated subcategories. Using specifi
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D. In a few sessions the therapists
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B1 Metaphorical investigations of t
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imaging. This becomes even clearer
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odily or meditative states. In cont
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7. Two case studies. A mimetic anal
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The two cases will be presented sep
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In fig. 7.1 the therapist has given
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the healing process and was a contr
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say: ’We don’t want it to work
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Level 3 Configuration is the core o
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Trials and Tasks Observes a grey ar
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pre-test level at follow-up, while
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She knew that her own scores had no
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In fig. 7.3 the therapist has given
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eflections on the predominance of e
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and I might as well accept it. Roge
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childish, playful.” From an initi
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solution through a message, and in
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Figure 7. 4 INLAs QLQ-C30 scores, i
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• the courage to confront dangers
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e observed, also in this axis, that
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’story line’ and writes a story
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Table 7. 7 A grounded theory model
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episodes dominated by (inner) body
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8. Analysis of music and imagery Th
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8.1.1 Qualitative music research In
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This means that: Description is nev
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methods intended for analysis of (p
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following preparations: 1. Informat
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An Eclectic Approach to the analysi
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was used to investigate potential c
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Figure 8. 2 The dynamic profile of
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there was dialogue between solo ins
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were used partially (in 35 sessions
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Following the guidelines of HMA the
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Figure 8. 4 Intensity Profile of Br
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Figure 8. 5 The digitized waveform
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for assessment. In this project the
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score it is possible to see exactly
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B2 (46-51) V/E Ot B3 (52-55) E Ot V
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C2 (91-100) R R V/S V/E C3 (100-106
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The analysis of the unfolding image
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she only reports verbally that she
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• The complete narrative, based o
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an experience further before finish
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Figure 8. 6 Intensity profile - Bac
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This profile - or map of the’ inn
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Table 8. 4 Event structure analysis
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A5+t (14-16) B1+t (17-21) R S S R V
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B5 (37-39) B6 (39-41) answered tona
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V and irritated, not R wanting to s
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ANHO: The client still has difficul
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For the five of the six participant
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• Analysis of the image potential
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Text and music with accompaniment w
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section of music that visually illu
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intensity increasing feature is the
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A1 (1-10) R/V E S/E B1 (11-21) R/V
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B1 Mein Jesu A1 (1-6) V R E R S V A
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B B3 (after music) E E S side? (tea
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Jesu evoked images related to death
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String Quartet as the most challeng
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Figure 8. 12 Distribution of the th
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Table 8. 7 A grounded theory model
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the imagery: the client reacts with
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9. Discussion “..Where the mind i
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possible to show a decrease in both
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9.1.3 The role of music and imagery
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specific therapeutic influence in t
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or measurable influence on the part
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As these findings are not consisten
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adiotherapy treatment. These commen
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this study (the only exception bein
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and why they are comprehensible and
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was that core images did emerge and
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actually no alternative to “will
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9.2.3.3 The proposed grounded theor
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This leads to the critical question
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The proposed grounded theories cove
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eautiful room with candles, flowers
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eventual climaxes and peak points c
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The three categories illustrated in
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scores are influenced by my negativ
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9.4 The development of new theoreti
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9.4.2 Heuristic music analysis as c
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client’s playing in improvisation
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Anxiety and anger are very importan
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Bonny found that the musical elemen
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support and explain how BMGIM can b
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9.6 Directions for future research
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comparative analysis including a nu
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music listening has been substantia
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What elements are there that descri
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1) Can ten BMGIM sessions improve t
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After every session questionnaires
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The analyses of metaphors and image
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not be sufficient to saturate a sub
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hvordan BMGIM kan have en positiv v
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individuelle BMGIM-sessioner, som r
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C30-scores viste stigninger i genne
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• Heuristisk Musikanalyse (Brusci
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som velegnet til psykosociale under
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REFERENCES (2002). Appendix B: Musi
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Ansdell, G. (2001). Musicology: mis
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Bonde, L. O. (2002). Introduction t
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Bonny, H. L. and L. K. Marids (2001
Page 409 and 410:
Clark, M. (1998). The Bonny Method
Page 411 and 412:
Ferguson, D. N. (1960). Music as Me
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Hilliard, R. E. (2002). The effects
Page 415 and 416:
Keiser, L. H. (1986). Conscious Lis
Page 417 and 418:
Mahns, W. (1998). Symbolbildungen i
Page 419 and 420:
Munro, S. (1993). "Music therapy in
Page 421 and 422:
Robbins, C. and C. Robbins (1991).
Page 423 and 424:
Short, A. E. (1997). "Jungian arche
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Tüpker, R. (1988). Ich singe was i
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Zachariae, B. (1997). "Forestilling
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LIST OF APPENDICES LIST OF APPENDIC
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Appendix 4.1 Data on six participan
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ESMA: 65 years old, married, three
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Appendix 4.2 Patientinformation (in
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Appendix 4.3 The HADS questionnaire
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Spørgs - mål nr. Vælg ét svar f
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Appendix 4.4 The EORTC QLQ-C30 ques
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427
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Fig. 5.14 ESMAs QLQ profile 120 100
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Fig. 5.18 WIFUs QLQ profile 120 100
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Appendix 6.2 Illustration of the de
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435
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henføre dem entydigt til noget som
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Ja. Hvert eneste gang har det være
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Det er meget rigtigt. Jeg har jo ik
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omgangshøjde endnu. Det er 2-3 år
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Ham ville jeg godt hilsen velkommen
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them out. Questionnaires like these
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it is the music! No, it is not only
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Maybe it influences me so strongly
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the music should be different. (…
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[Are there other images that you…
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Ja det tror jeg. Hvor er det lige j
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drømme jo også - de kommer også
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De hører fuldt ud sammen. Hvis man
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[The questionnaires indicate that y
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guess it has been working in the su
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them, many stairs and things like t
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Appendix 6.4.3 Interview med ESMA 9
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været mere eller mindre på afstan
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skørt, for det er virkelig svært
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den der kæmpeindsats, som jeg har
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emærker at de er der - de skal bek
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jeg ville nødig undvære musikken
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[Folkene bag spørgeskemaerne hævd
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Nej desværre ikke. Altså sådan m
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Nej ikke nødtvungent! ... Men det
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Ja, og jeg føler, at jeg ’fylder
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Der er lissom om jeg er på den and
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meget, og også at give fred; men o
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sådan det er. (Jeg sider og prøve
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[Men hver anden uge er meget passen
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andet sted at jeg har haft meget ti
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f.eks. ’Du er blevet meget mere a
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Og så får jeg lyst til at lave no
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der har arbejdet med de her ting? H
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Berlioz: 4 X PIJØ: #3,2 7 1 L’en
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Marcello: Oboe Concertor, 2nd movem
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WIFU #2 1 ANHO #1 1 4 NURTURING 2-5
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Appendix 8.2.1a. Session notes PIJ
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#5 9.12. Disc OK Bekymring for frem
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#7 14.1 Disc: kun de første 10’
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egge to. Ah! Ingen kamp, så. Sving
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#3 13.11, Disc OK #4 26/11 Disc OK
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#6 3.1.03 Disc OK #7 14.1 Has felt
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#9 20.02. Disc OK #10 5.3. Disc OK
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Appendix 8.2.2a Session notes INLA
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#5 3.1.03 Disc OK #6 15.1. Disc OK
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#8 24.02. Disc OK #9 17.03 Til US b
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Appendix 8.2.2b Session notes INLA
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#5 3.1.03 Disc OK #6 15.1. Review o
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#8 24.02. Disc OK Control examinati
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FOCUS: Finding a way out... a door.
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#3 13.11. Disc OK #4 21.11 Disc: ku
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#7 19.12. Dis OK #8 30.1. Ingen opt
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Appendix 8.2.4 Session notes ANHO (
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Disc OK #6 7.1.03 Ingen optagels e
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# 10 31.03 Disc OK hul igennem. For
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OK #4 3.12 Disc OK #5 19.12. Disc O
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Disc OK #10 17.03. Disc OK Andre ha
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#3 19.11 Disc OK #4 28.11. Disc OK
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Disc OK #9 11.3. Disc OK Lang snak
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557
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Appendix 7.4 MINI-WORKSHOP - RESEAR
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Appendix 8.5 Brahms Score + Imagery
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• The movement is basically suppo
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Appendix 8.7 Bach: Komm süsser Tod
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Appendix 8.9 Analysis of selected m
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Element Brahms: Violin concerto - s
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Appendix 9.1 Types of clinical rele
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Appendix 9.2 Grocke’s Categories
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2. The relevance of the listening s
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directing the will” (p. 5). A who
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Reviewing the sub-questions, the wo
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Works Vol. IV, p. 7. The so-called
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ased on communication theory or cul
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In this study, I have used the thir
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24. The framework for the qualitati
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English translation of the intervie
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Dissertation - World Federation of Music Therapy

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