Medicine, Health Care and Philosophy

, Volume 17, Issue 4, pp 609–624 | Cite as

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

Scientific Contribution


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.


Narrative genres Narrative identity Transformation Muscular tension Sensation and awareness Norwegian psychomotor physiotherapy 


  1. Bair, M.J., J. Wu, T.M. Damush, et al. 2008. Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients. Psychosomatic Medicine 70: 890–897.CrossRefGoogle Scholar
  2. Braatøy, T. 1947/1979. De nervøse sinn 12 [The nervous minds 12]. Oslo: J.W. Cappelens Forlag.Google Scholar
  3. Braatøy, T. 1948/1952. Psychology versus anatomy in the treatment of arm neurosis with physiotherapy. The Journal of Nervous and Mental Disease 115:215–245.Google Scholar
  4. Breitve, M., M. Hynninen, and A. Kvåle. 2008. Emosjonelle symptomer og helseplager hos pasienter som oppsøker psykomotorisk fysioterapi [Emotional Symptoms and Health Complaints Seeking Psychomotor Physiotherapy]. Fysioterapeuten 12: 19–26.Google Scholar
  5. Bunkan, B., L. Radøy, and E. Thornquist. 1982. Psykomotorisk behandling [Psychomotor Treatment]. Oslo: Universitetsforlaget.Google Scholar
  6. Bunkan, B., and E. Thornquist. 1991. What is psychomotor physiotherapy?. Oslo: Norwegian University Press.Google Scholar
  7. Dragesund, T., and M. Råheim. 2008. Norwegian psychomotor physiotherapy and patients with chronic pain: Patient’s perspective on body awareness. Physiotherapy Theory and Practice 24: 243–254.CrossRefGoogle Scholar
  8. Ekerholt, K., and A. Bergland. 2004. The first encounter with Norwegian psychomotor physiotherapy: Patient’s experiences, a basis of knowledge. Scand J Public Health 32(6): 403–410. Google Scholar
  9. Ekerholt, K., and A. Bergland. 2006. Massage as interaction and a source of information. Advances in Physiotherapy 8: 137–144.Google Scholar
  10. Ekerholt, K., and A. Bergland. 2008. Breathing: A sign of life and unique area for reflection and action. Physical Therapy 88: 832–840.Google Scholar
  11. Frank, A. 1994. Reclaiming an orphan genre: The first-person narrative of illness. Literature and Medicine 13: 1–21.CrossRefGoogle Scholar
  12. Frank, A. 1995. The Wounded Storyteller. Body, illness, and ethics. Chicago and London: The University of Chicago Press.CrossRefGoogle Scholar
  13. Frank, A. 1998. Just listening: Narrative and deep illness. Families, Systems & Health 16: 197–212.CrossRefGoogle Scholar
  14. Frank, A. 2012. Practicing dialogical narrative analysis. In Varieties of narrative analysis, ed. J.F. HJG, 33–52. Los Angeles: Sage.Google Scholar
  15. Halkier, B. 2010. Fokusgrupper [Focusgroups]. Oslo: Gyldendal Norske Forlag AS.Google Scholar
  16. Ianssen, B. 2012. Norwegian psychomotor physiotherapy. Movement of life. Trondheim, Norway: Berit Ianssen (ed).Google Scholar
  17. Kitzinger, J. 2006. Focus groups. In Qualitative research in health care, 3rd ed, ed. C. Pope, and N. Mays. USA: Blackwell Publishing.Google Scholar
  18. Kristensson, B., and P. Kemp. 1992. Innledning [Introduction]. Från text till handling [From text to action]. Stockholm/Stehag: Brutus Östlings bokförlag. Symposion.Google Scholar
  19. Krueger, R., and M. Casey. 2000. Focus groups: A particular guide for applied research. Thousand Oaks: Sage Publications.Google Scholar
  20. Larun, L., and K. Malterud. 2011. Finding the right balance of physical activity: A focus group study about experiences among patients with chronic fatigue syndrome. Patient Education and Counseling 83: 222–226.CrossRefGoogle Scholar
  21. Lærum, E., S. Brage, C. Ihlebæk, et al. 2013. Et muskel- og skjelettregnskap. Forekomst og kostnader knyttet til skader, sykdommer og plager i muskel- og skjelettsystemet [A Musculosceletal Accounting. Prevalence and Expenses Associated with Injuries, Diseases and Ailments of the Musculoskeletal System].Google Scholar
  22. Løgstrup, K. 1956/2000. Den etiske fordring [The Ethical Demand]. J.W. Cappelens Forlag.Google Scholar
  23. Løgstrup, K. 1968/1994. Opgør med Kierkegaard [Settlement with Kierkegaard]. Copenhagen: Gyldendal.Google Scholar
  24. Løgstrup, K. 1976. Vidde og prægnans. Sprogfilosofiske betragtninger. Metafysik I [Width and reconance. Languagephilosophical reflections. Metaphysics I]. Copenhagen: Gyldendalske Boghandel, Fordisk Forlag A.S.Google Scholar
  25. Løgstrup, K. 1978. Skabelse og tilintetggørelse. Metafysik 4 [Creation and destruction. Metaphysics lV]. Copenhagen: Gyldendal.Google Scholar
  26. Løgstrup, K. 1983a. Kunst og erkendelse. Metafysik ll [Art and apprehending. Metaphysics ll] Copenhagen: Gyldendal.Google Scholar
  27. Løgstrup, K. 1983b. System og Symbol. Essays [System and Symbol. Essays]. Copenhagen: Gyldendal Bokhandel, Nordisk forlag AS.Google Scholar
  28. Løgstrup, K. 1984. Ophav og omgivelse. Metafysik lll [Origin and environment. Metaphysics lll]. Copenhagen: Gyldendal.Google Scholar
  29. Løgstrup, K. 1987/1993 Solidaritet og kærlighed [Solidarity and Love]. Copenhagen: Gyldendal.Google Scholar
  30. Løgstrup, K. 1995. Metaphysics. Milwaukee: Marquette University Press.Google Scholar
  31. Løgstrup, K. 1997 The Ethical Demand. Notre Dame, Indiana University of Notre Dame Press.Google Scholar
  32. Madriz, E. 2003. Fokus groups in feminist research. In Handbook of qualitative research, ed. N. Denzin, and Y. Lincoln. Thousand Oaks: Sage Publications.Google Scholar
  33. Malterud, K. 2012. Fokusgrupper som forskningsmetode for medisin og helsefag [Focus groups as research method for medicine and health care]. Oslo: Universitetsforlaget.Google Scholar
  34. Mattingly, C. 1998. Healing dramas and clinical plots. Cambridge: Cambridge University Press.Google Scholar
  35. Mattingly, C. 2000. Emerging narratives. In Narrative and the cultural construction of illness and healing, ed. C. Mattingly, and L.C. Garro. Berkley and Los Angeles: University of California Press.Google Scholar
  36. Mattingly, C. 2010. The Paradox of Hope. Journeys through a clinical borderland. California: University of California Press.Google Scholar
  37. Morgan, D.L. 1997. Focus groups as qualitative research. London: Sage Publications.Google Scholar
  38. Rendtorff, J. 2000. Paul Ricoeurs filosofi [Paul Ricoeur’s philosophy]. København: Hans Reitzels forlag.Google Scholar
  39. Ricoeur, P. 1984. Tale og skrift [Speech and Text]. In Sprog. Tale og skrift, ed. P. Kemp. Århus: Aros.Google Scholar
  40. Ricoeur, P. 1991. Life: A story in search of a narrator. In A Ricoeur reader. Reflection and imagination, ed. M. Valdés, 425–437. New York: Harvester Wheatshaft.Google Scholar
  41. Ricoeur, P. 1992. Oneself as another. Chicago: The University of Chicago Press.Google Scholar
  42. Ricoeur, P. 2004. Memory, history, forgetting. Chicago: The University of Chicago Press.Google Scholar
  43. Steihaug, S., B. Ahlsen, and K. Malterud. 2002. “I am allowed to be myself”: Women with chronic muscular pain being recognized. Scandinavian Journal of Public Health 30: 281–287.CrossRefGoogle Scholar
  44. Steinsvik, K. 2008. Kunnskap om kroppen mellom grep og begrep [Knowledge on the Body between Grasp and Concept]. Yrkeskunnande förIndustriell ekonomi och organisation, 217. Stockholm: Kungliga Tekniska Högskolan.Google Scholar
  45. Sudman, T. 2009. (En)gendering body politics. Physiotherapy as a window on helath and illness.. Department of Public Health and Primary Care. Dissertation for the degree of Philosophiea Doctor, University of Bergen.Google Scholar
  46. Sviland, R., K. Martinsen, and M. Råheim. 2007. Hvis ikke kropp og psyke—hva da? [If not body and mind—then what?]. Fysioterapeuten 12: 23–28.Google Scholar
  47. Sviland, R., M. Råheim, and K. Martinsen. 2009. Å komme til seg selv—i bevegelse, sansning og forståelse [To Come to Onself—In Movement, Sensation and Understanding]. Matrix 2: 257–275.Google Scholar
  48. Sviland, R., M. Råheim, and K. Martinsen. 2010. Språk—uttrykk for inntrykk [Language—Expressions of Impressions]. Matrix 2: 132–156.Google Scholar
  49. Sviland, R., M. Råheim, and K. Martinsen. 2012. Touched in sensation—Moved by respiration. Embodied narrative identity—A treatment process. Scandinavian Journal of Caring Sciences 26: 811–819.CrossRefGoogle Scholar
  50. Thornquist, E. 2006. Face-to-face and hands-on: Assumptions and assessments in the physiotherapy clinic. Medical Anthropology 25: 65–97.CrossRefGoogle Scholar
  51. Øien, A. 2013. Fortellinger mellom nærhet og avstand til kroppslig erfaring [Retrospective and emergent narratives of embodied experiences]. Fysioterapeuten 3: 22–26.Google Scholar
  52. Øien, A., S. Iversen, and P. Stensland. 2007. Narratives of embodied experiences—Therapy processes in Norwegian psychomotor physiotherapy. Advances in Physiotherapy 9: 31–39.CrossRefGoogle Scholar
  53. Øien, A., S. Steihaug, and M. Råheim. 2010. Communication as negotiation process in long term physiotherapy: A qualitative study. Scandinavian Journal of Caring Sciences 25: 53–61.CrossRefGoogle Scholar
  54. Øien, A.M., M. Råheim, S. Iversen, et al. 2009. Self-perception as embodied knowledge—Changing processes for patients with chronic pain. Advances in Physiotherapy 11: 121–129.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Randi Sviland
    • 1
  • Kari Martinsen
    • 2
  • Målfrid Råheim
    • 1
  1. 1.Department of Global Public Health and Primary Care, University of BergenBergenNorway
  2. 2.Harstad University College and Haraldsplass Deaconess University CollegeBergenNorway

Personalised recommendations