From pain through chaos towards new meaning: Two case studies

Bullington, Jennifer; Sjöström-Flanagan, Charlotte; Nordemar, Kristina; Nordemar, Rolf

doi:10.1016/j.aip.2005.04.007

Cited by 13 publications

(15 citation statements)

References 17 publications

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“…When one has become pain and the world is pain, there is little space for the personal self. My own research has shown that it is just as dehabilitating to find one's personal sense of self reduced to pain as it is to experience the painful body and the pain-filled world [3,4,12]. One patient in a study on the experience of moving with persistent pain [4] expressed this in the following way: ''I am a person who was always busy, I was never still, I was always on the road, and I loved it.…”

Section: Chronic Painmentioning

confidence: 94%

Embodiment and Chronic Pain: Implications for Rehabilitation Practice

Bullington

2009

Health Care Anal

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Throughout the Western world people turn towards the health care system seeking help for a variety of psychosomatic/psychosocial health problems. They become "patients" and find themselves within a system of practises that conceptualizes their bodies as "objective" bodies, treats their ill health in terms of the malfunctioning machine, and compartmentalizes their lived experiences into medically interpreted symptoms and signs of underlying biological dysfunction. The aim of this article is to present an alternative way of describing ill health and rehabilitation using the philosophy of Maurice Merleau-Ponty in order to deepen our understanding of the rehabilitation process. I will explore how the experience of chronic pain ruptures the natural connection between body and world and how the rehabilitation process can be understood as the re-insertion of the body into the flow of experience, where the body "disappears" into its natural silence in order to allow the world to once again unfold. The experience of chronic pain places the painful body in focus, resulting in a diminished articulation of both self and world. Persons with illness suffer not only from the physical aspects of pain and discomfort but also from a loss of identity where one feels alienated and detached from things that used to give meaning to ones life. Rehabilitation must not only address the material (medical) body but also the diminished sense of self as well as the retreat from the world outside of the painful body.

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Section: Chronic Painmentioning

confidence: 94%

Embodiment and Chronic Pain: Implications for Rehabilitation Practice

Bullington

2009

Health Care Anal

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“…Denna möjlighet har använts av fysioterapeuter när de t.ex. använt målning, musik eller dans som alternativa vägar för patienter att uttrycka sin smärta (79). Nyckelfrågornas möjliga kreativa roll beskrivs inte explicit i Malteruds dialogmetod (114).…”

Section: Frågorna Som Behandlingunclassified

Att leva med en kropp som värker : samtal med fysioterapeuten

Afrell¹

2014

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Background and aim: Physiotherapists in primary care meet, assess and treat patients with long-standing benign musculoskeletal pain. As a clinical condition, long-standing pain is common but nonetheless it is quite complex. The aim of this thesis has been, from a bodily existential perspective, to investigate and conceptualise the experience of living with longstanding benign musculoskeletal pain, and from there, to work out a method for conversation and assessment within non-specialised physiotherapy. Methods: Our first study was an interview study where we applied a phenomenological approach and investigated the ways individuals suffering from long-standing pain experienced their body and their illness. Four aspects of body experience were described, and based on these aspects, four typologies of attitudes to pain were distinguished. In the second study, we made two group interviews with six physiotherapists about their experiences of using, in their clinical work, questions from the interview guide in study I that had given particularly rich responses. Transcripts were analysed using phenomenography. In the third study, patients’ verbal responses to the key questions, directed to them by physiotherapists in clinical situations, were investigated, and the four aspects of body experience from study I formed the concepts of a deductive analysis. In study IV, finally, the key questions and typologies were tried by a larger group (31), and their experiences and the possible applicability of the method were studied by qualitative content analysis combined with the counting of codes. Results: We created four typologies of attitudes to long-standing pain: “Surrendering to one’s fate”, “Accepting by an active process of change”, “Balancing between hope and resignation” and “Rejecting the body”. These typologies, in turn, were based on four aspects of body experience: “The body as an aspect of identity”. “Body reliance”, “Body awareness”, and “Ways of understanding pain”. In study II, by the aid of key questions, patient and physiotherapist managed to have a conversation on bodily existential matters. The physiotherapist learnt to know the patient as a person, a process appeared to be initiated in the patient, and their relation changed. The patient was willing to talk about her body in pain, and had the words to do this. In study III, the key questions opened ways to reflections on body, existence, and biography. The four aspects of body experience were central to the patients’ descriptions. In study IV, the participating physiotherapists reported by large positive experiences from applying key questions and typologies. The patients reflected, emotions were evoked, and the relation and the communication often improved. The typologies helped in giving a comprehensive perspective of the patient’s problem, and to grasp where in the process of rehabilitation the patient was to be found. Conclusions: The method, seven key questions combined with the tentative frame of interpretation of the answers, seemed to be easily appl...

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“…They were audio-recorded and fully transcribed. The interviews were wide-ranging and semi-structured, starting with a 'grand tour' question that invited Like Bullington et al (2005), and Whitehead (2006), the authors used no preset method of analysis. No assumptions were made at the outset regarding the types of narratives that might be present in the interview material.…”

Section: Procedurementioning

confidence: 99%

“…As shown by Borgmann (2002) and by Bullington et al (2005), case studies provide an opportunity to examine both the recurring and distinctive patterns in participants' narratives about art. Whilst simple generalisation from the findings is not possible, case studies can provide insights that contribute to theory-building and therapy practice (Yin, 1994).…”

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confidence: 99%

“…She connected her past, present and future self in symbolic ways through, for example, drawing a bridge, map and landscape in which she placed herself. Bullington, Sjöström-Flanagan, Nordemar & Nordemar (2005) presented case studies of two women who engaged in expressive arts therapy to cope with fibromyalgia pain of uncertain origin. One engaged primarily in dance movement therapy and the other engaged in music therapy and drawing.…”

mentioning

confidence: 99%

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Narratives of art-making in chronic fatigue syndrome/myalgic encephalomyelitis: Three case studies

Reynolds

Vivat

2006

The Arts in Psychotherapy

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art-making in chronic fatigue syndrome/ myalgic encephalomyelitis: three case studies. Arts in Psychotherapy, 33, 435-445. AbstractThis paper explores the narratives of three women who had lived with severe chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) for many years, and who engaged in art-making as a leisure activity rather than for psychotherapy. Three distinct narratives about the role of art-making in CFS/ME were inferred. One participant represented art as a way of filling time rather than having further psychological significance. In her narrative, art provided satisfaction but also functioned as a witness to time and opportunity that had been lost to an unchanging illness. The second participant narrated both illness and art-making as intertwined journeys towards a more able and useful self. Her narrative had features of the quest described in previous typologies. The third participant also provided a quest narrative, but her struggle focused inwards on understanding her feelings about her illness and its effects on her life. The analytic focus on narrative revealed the distinctive constructions of illness and art-making that are usually submerged when qualitative analysis focuses on themes common to groups of participants. These narratives of artmaking in CFS/ME have relevance to understanding the multi-faceted therapeutic benefits of art.

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From pain through chaos towards new meaning: Two case studies

Cited by 13 publications

References 17 publications

Embodiment and Chronic Pain: Implications for Rehabilitation Practice

Embodiment and Chronic Pain: Implications for Rehabilitation Practice

Att leva med en kropp som värker : samtal med fysioterapeuten

Narratives of art-making in chronic fatigue syndrome/myalgic encephalomyelitis: Three case studies

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