Music and its meaning: an interpretative phenomenological analysis of the experience of chronic pain sufferers use of music as a therapeutic intervention

Background Chronic pain is a widely reported phenomena in today’s population. Chronic pain results in suffering that can be destructive and disabling, and this currently affects all age groups. The chronic pain sufferer seeks out allopathic pharmaceutical treatments that may offer some temporary pain relief, but at what cost? Both psychologically, and physically, the complexities and side effects of the pain and the treatment plan have their observable effects. Over the past two decades, a small number of empirical studies have been carried out on an alternative approach to ‘dealing with the pain’: listening to music (Schorr, 1993; McCaffrey & Freeman, 2003; Gold & Clare, 2012). Participants’ self-selected music-listening is a documented therapeutic intervention that offers the potential to improve psychological and physical well-being in chronic pain sufferers. Aims The aim of this thesis was to explore how chronic pain sufferers experience and make sense of listening to music therapeutically. Two key objectives of the study were as follows: 1) to examine how music-related experiences can help people self-manage their chronic pain, and 2) to explore whether listening to music can support people’s coping strategies. The research question for this thesis is: how do people with chronic pain make sense of the experience of listening to music therapeutically? Methodology Interpretative phenomenological analysis (IPA) was the qualitative analysis method utilised, as it is aptly concerned with the processes, novelties, and complexities of the participants’ accounts. IPA has its roots embedded in “three key areas of philosophy of knowledge: phenomenology, hermeneutics and idiography” (Smith et al., 2009, p. 11) making IPA an ideal method in the current study for the exploration of the lived experience and in support of how meanings are constructed utilising the influence of symbolic interactionism, by the individual within both the social and personal world (Eatough & Smith, 2008; Smith, Flowers & Larking, 2009). IPA is still firmly connected to its phenomenological origins, as indicated by Smith and Osborn (2003), through its recognition of the ‘double hermeneutics’ of the investigative process; IPA rationally combines both an empathic and a questioning approach in its analyses. Furthermore, IPA offers a method that is within the existential-phenomenological paradigm and has the potential to demonstrate the strengths of existential phenomenological research (Shinebourne, 2011a). Participants took part in the study for seven days. They were all out-patients who were diagnosed with a range of chronic pain conditions. Participants completed semi-structured interviews. The music listening intervention was carried out in the participants’ homes. Participants downloaded their music selection onto an iPod (MP3 player). Findings Five women (62.5%) and three men (37.5%) participated in the study. They ranged in age from 34 to 65 years old (mean age 49.6). Three super-ordinate themes emerged from the interviews: (1) Life before pain; (2) Shifting the perception of chronic pain; and (3) Refection on Music listening as a coping strategy. The participants showed a preference for music that evoked specific mood and arousal states in order to regulate emotions in everyday situations, such as their chronic pain episodes. The super-ordinate themes; Life before pain and shifting the perception of chronic pain were common themes for all of the participants; this showed the process of engagement with music and their interpretation, providing a possible glimpse at the psychological processes that underpin their lived experiences. Reflections were made on a range of cognitive-affective and sensory responses, describing music-related regulation processes: there was a sense that a process of change was taking place. Conclusion It was concluded that fifteen minutes of music listening, twice a day, was sufficient to record perceived changes in pain perception, and to enable the listener to connect to past memories. Their mood states were perceived as being improved, and some participants noted reductions in pain during the process. The findings suggest that participants’ self-selected music listening had an impact on psychological functioning and perceived pain. Participants’ meanings through their lived experience of pain and self-selected music were potential modifiers of cognitive-affective dimensions and existential resource (individual’s search for meaning for the future via their own resilience and coping strategies) as described in their stories of evoked nostalgia, temporality of pain, distraction and imagery, which evoked in participants’ heightened arousal and autobiographical memories. Future research projects would benefit from exploring the meaning of temporal distance in terms of pain and existential threat (future)