Dissertation - World Federation of Music Therapy

The scale of Klein et al. was not used in this study, however especially level 3-7 of
the scale might lend themselves to a description of how BMGIM clients develop their
verbal metaphoric reporting style. The scale does not explicitly mention metaphors or
images as elements in the reporting style, however it is clear that these five levels can
be identified in the music-listening parts of the BMGIM session (see chapters 6 to 8),
and that emotional-cognitive integration is the agenda of the postlude (or post-session
dialogue).
Metaphors have played a role in the history of psychotherapy since Freud, who made
extensive use of them both in his case studies and in his theories. From a more
practical point of view metaphors have taken a prominent position during the last two
decades. Many psychotherapists advocate the use of metaphors (and narratives) in
clinical practice as an aesthetic and emotionally engaging component, furthering
subjective and symbolic meaning – as opposed to what Bruner called the
“paradigmatic” aspects, the rational and logical acknowledgment of objective
meaning (Hougaard 2004, p. 547-562). The modal ambiguity and the presentational
form of imagery and metaphors are regarded well suited to activate emotions and
representational systems located in the right hemisphere (Cox and Theilgaard 1987).
There is very little empirical research evidence for a positive outcome of the use of
metaphors in psychotherapy. However, in a qualitative study Angus and Rennie
(1989) found that metaphors in most cases was a constructive element in
psychotherapy, and McCullen (1989) found in a comparison of three successful and
three less successful psychodynamic short time therapies that the successful therapies
were characterized by the use of imaginative language and by the development of a
core metaphor with related conceptual figures (Hougaard 2004). An important point
is that metaphors suggested by the client him- or herself are much more powerful than
metaphors suggested by the therapist as part of an interpretation.
Summary
All of these examples illustrate the need in psychotherapy to describe the unique in-
between-areas of the therapeutic encounter that Kast (1990) metaphorically called
“the area between inner and outer world”. In psychotherapy, therapist and client are
walking together on a bridge, connecting the banks of cognitive understanding with
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