To be held and to hold one’s own: narratives of embodied transformation in the treatment of long lasting musculoskeletal problems

Abstract

This study elaborates on narrative resources emerging in the treatment of longlasting musculoskeletal and psychosomatic disorders in Norwegian psychomotor physiotherapy (NPMP). Patients' experiences produced in focus group interviews were analyzed from a narrative perspective, combining common themes across groups with in depth analysis of selected particular stories. NPMP theory expanded by Løgstrup's and Ricoeur's philosophy, and Mattingly's and Frank's narrative approach provided the theoretical perspective. Patients had discovered meaning imbued in muscular tension. Control shifted from inhibiting discipline and cognitive strategies, towards more contingence with gravity and sensation, and increased freedom to be what and who they were. Trust, time, open speech, and being respectfully listened to were described as therapeutic pre-conditions. The body was experienced as the source of their voice as their own. As tension patterns transformed, novel experience in sensation appeared to feed narrative imagination, reshaping past plots, embodied identity and future prospects. NPMP was disclosed as a treatment integrating detection, battle and repair as narrative subplots, but the core narrative was the journey of transformation. Novel embodied narrative resources nourished the quest for a life and identity in tune with the body as one's own.

Opening toward life: Experiences of basic body awareness therapy in persons with major depression

“…The temporal elasticity in the experiences of BBAT, expressed through immediate embodied recognition, recalling, and verbalization of life-events, could be regarded as an aspect of body memory (Koch, Caldwell, & Fuchs, 2013 ). Our results can also be related to the recent studies of Norwegian Psychomotor Physiotherapy, which illuminate patients’ process of transformation through new experiences in movement and in sensation, with the new experiences feeding their narrative imagination and reshaping past plots, embodied identity, and future prospects (Sviland, Martinsen, & Råheim, 2014 ; Sviland, Råheim, & Martinsen, 2012 ).…”

“…Movement-based embodied contemplative practices (Schmalzl, Crane-Godreau, & Payne, 2014 ) have recently received increased attention in the treatment of depression, for example mindfulness meditation (Teasdale et al, 2000 ), yoga (Balasubramaniam, Telles, & Doraiswamy, 2013 ; Cramer, Lauche, Langhorst, & Dobos, 2013 ), tai chi (Lavretsky et al, 2011 ; Tsang et al, 2013 ), and dance and movement therapy (Koch, Kunz, Lykou, & Cruz, 2014 ). The suggested working mechanisms are biological and neurological mechanisms that are shared by other types of physical activity, but recent theories also highlight neurophenomenology and enactive dimensions (Schmalzl et al, 2014 ).…”

Løgstrup’s thinking: a contribution to ethics in physiotherapy

“…Løgstrup argued that poetic and ethical understandings of life originate from the same sensuous source, and thus have the capacity to bring to the fore essential meaning. A patient's experience 15 may illustrate this (Sviland, Martinsen, and Råheim, 2014). For five years, Joanna had suffered a lot of pain and her balance had been very poor after a whiplash injury.…”

“…The encounter with a person from the past was a moment of revelation to Joanna; a ground-breaking existential moment of coming to herself where she had acted in a new way. Here body seemed to have become more supportive of her action and narration in tune with herself as a person (Sviland, Martinsen, and Råheim, 2014).…”

“…Joanna shared this story with other patients in a focus group interview about their experience with Norwegian Psychomotor Physiotherapy. A more indepth analysis can be found in Sviland, Martinsen, and Råheim (2014).…”