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IN THE COMPANY OF MUSIC AND ILLNESS: THE EXPERIENCE AND MEANING OF MUSIC LISTENING FOR WOMEN LIVING WITH CHRONIC ILLNESS by JENNIFER JAMES NICOL B.Mus., University of British Columbia, 1986 B.M.T., Wilfrid Laurier University, 1988 M.A., University of British Columbia, 1993 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE STUDIES (Department of Educational and Counselling Psychology, and Special Education) We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA November 2001 © Jennifer James Nicol, 2001 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. DE-6 (2/88) 11 SYNOPSIS OF THE EVENING'S PREMIERE I ABSTRACT The purpose of this study was to contribute an experiential understanding of everyday "music listening experiences through a text that also conveyed a pathic way of knowing. I studied the phenomenon of music listening in the particular context of women living with chronic illness (i.e., a physical condition that is managed rather than cured), and in keeping with van Manen's (1990, 2000) applied hermeneutic-phenomenological approach. Van Manen's approach to phenomenological inquiry emphasizes implementation of the reductio (the reduction), attention to the vocatio (the vocative dimension), and the use of empirical and reflective methods to generate and analyze data. The question that guided this study was: What is the lived experience and lived meaning of music listening for women living with chronic illness? Six women were interviewed in multiple conversations about their music listening experiences. All lived with chronic illness, and identified music listening as important in their lives. Following an initial analysis based on multiple readings from holistic, selective, and detailed perspectives, I used a guided existential reflection based on lived body, lived time, lived space, and lived relation to further understand, organize, and reveal the many ways in which the women listened to music. Writing and rewriting in a reflective and dialogical manner were grounding elements of analysis. 1 Suggestive terminology is used through the present study in order to create a poetic and vocative text, which is an integral part of van Manen's (1990) applied hermeneutic-phenomenological method. The dissertation is envisioned as a premiere performance of "A Sonata to Show" (Chapter IV), framed by a "Prelude" (Chapter I) and "Postlude" (Chapter V), and accompanied by "Concert Notes" (Chapter II) to orient listeners, an "Eavesdropping Behind the Scenes" (Chapter III) to overview the technical matters associated with the creation and launch of the work, as well as a "Programme" (Table of Contents) and "Synopsis of the Evening's Premiere" (Abstract). Ill Findings contribute in several ways. Most broadly, the final text was constructed to communicate an understanding that is embodied and discursive (i.e., knowledge as participation), and that leads to personal formative knowledge (i.e., knowledge as being). As a phenomenology of music listening, results suggested that to listen to music is to be in the company of music; that is, to be with a longtime companion who ultimately aids in accommodating the unanticipated arrival of chronic illness. Implications include future research to further investigate the complex, relational dynamics associated with music listening experiences, as well as the possibility of the body as a source of knowledge (i.e., mind-body), acting as a musical compass in music listening experiences. Implications for counselling practice are also described. iv PROGRAMME I TABLE OF CONTENTS Synopsis of the Evening's Premiere/ Abstract .ii Programme / Table of Contents ; iv Credits / Acknowledgements vii Offering to the Muses / Dedication viii CHAPTER I: PRELUDE / INTRODUCTION 1 CHAPTER II: CONCERT NOTES / LITERATURE REVIEW 8 Chronic Illness 10 Western Medical Context 10 Biomedical Perspective 11 Anthropological and Sociological Perspectives 12 Psychological Perspectives 14 Research Context . 16 Defining Chronic Illness 17 Representation and Sampling Issues 18 Design Issues ; 18 Personal Context 19 Women and Chronic Illness 19 Frameworks of Illness 21 Themes of Loss, Meaning, and Transformation 24 Summary of the Chronic Illness Literature 34 Music 35 The Phenomenon of Music 35 Historical and Contemporary Perspectives 36 The Phenomenon of Listening ; 44 Communication Perspectives 44 Therapeutic Perspectives. 45 The Phenomenon of Music Listening 49 Empirical Research 51 Theoretical Research . 53 Popular Press 55 The Phenomenon of Music Listening in the Context of Chronic Illness 58 Summary of the Music Literature 63 Formulating the Research Question 64 CHAPTER UI: "EA VESDROPPING BEHIND THE SCENES " / METHODOLOGY 68 Situating the Inquiry 68 Phenomenological Philosophy 69 Phenomenological Methods of Inquiry 70 Van Manen's Applied Hermeneutic-Phenomenology 73 Summary of the Present Study's Method 75 Data Generation 76 Turning to the Nature of Lived Experience 76 Techniques of Phenomenological Reduction 78 Investigating Experience as We Live It 79 Participants 80 Texts .82 Data Analysis 82 Hermeneutic Phenomenological Reflection and Writing 83 Guided Existential Reflection 83 Writing as Analysis .84 Writing for a Vocative Text 85 Parts and Whole, and Maintaining Relation to the Phenomenon 86 Ethical Considerations .87 Epistemic Criteria 88 Representation ; 88 Legitimation 90 Moral and Pragmatic Criteria . 92 CHAPTER IV: PREMIERE OF "A SONATA TO SHOW" I RESULTS 95 Composer's Notes I Logistical Considerations 95 Orchestral Tuning / Phenomenon Attunement: Listening and Hearing Music 96 Exposition / In the Company of Music and Illness 98 Six Voices A Cappella / The Women's Stories 99 Laurie 99 Jean .101 Storm 103 Celia .106 Iris 108 May . .111 Vibrato/A Seventh Woman _114 Contrary and Parallel Motion in Chronic Illness / Stories of Contrast and Commonality 116 Contrary Motion / Stories of Contrast 116 Parallel Motion / Stories of Commonahty 117 Development/Listening and Hearing Music in Illness 120 Ensemble For Voices In Counterpoint/ Six Stories Merged 120 Music Embodied: A Musical Compass ; 120 Music Time: Time-Less, Time-Full, Time-Encored, Time-Tabled .124 Musical Spaces: Places to Listen, be Music-Held and Music-Freed_129 Musically Related: With others, with Self, with Music 132 In Chorus: Body, Time, Space, Relation 135 Chorus Out: Unwelcome Music 136 Recapitulation /Lived Experience and Lived Meaning 138 Da Capo / Starting Again 138 Ways of Listening "for" Music in Illness 138 Ways of Listening "to" Music in Illness 139 Hearing Differently to Hear Anew 142 Coda/ A Place to Cadence _144 CHAPTER V: POSTLUDE/DISCUSSION _146 Summary of the Inquiry 146 Limitations of the Inquiry 148 Phenomenology as Practice .150 Phenomenology as Pathic Knowing 151 Phenomenology as Tact 151 The Inquiry as a Phenomenology of Music Listening 152 Music Listening with a Walkman 152 Music Listening and Voice ; 154 Phenomenological Dissertations on Music Listening 155 Spontaneous Music Listening Over a Week 156 Listening to Personally Meaningful Music 157 Conclusion 159 The Inquiry as a Contributor to the Extant Literature 160 Unanticipated Findings : 161 The Concept of Somatic Awareness / Mind-Body 161 The Concept of Social Support as a Stress and Coping Resource 163 Implications for Future Research 164 Implications for Counselling Practice 165 The Last Note 167 REFERENCES / Discography 168 APPENDICES / Scores 182 Appendix A: Pilot Interview 182 Appendix B: Poster Advertisement Used to Solicit Participants 184 Appendix C: Telephone Screening Protocol 185 Appendix D: Descriptions of Participants' Illnesses 186 Appendix E: Interview Questions ; 188 Appendix F: Informed Consent Form 189 Appendix G: Illness Autobiographies 191 Appendix H: Other Sources of Data 193 Appendix I: Ethics Approval Vlll CREDITS I ACKNOWLEDGEMENTS I have come to realize that personal accomplishments are moments of a shared nature. As I feel the enormous satisfaction of completing my doctoral research and studies, I am aware of all those who stand here with me, and who I want to acknowledge with great appreciation and gratitude. My supervisor, Dr. Bonnie Long and committee members—Drs. Joan Bottorff, Carolyn Kenny, and Richard Young—offered me expertise, partnership, and a solid foundation upon which to build; My family members provided me with love, laughter, and loyalty, and never ever questioned my long studenthood. My friends supported me with companionship and constancy; My past and present colleagues, which includes the six women of this inquiry and other "phinishers" at the PhinisheD website, contributed themselves so I could learn and grow; My children's childcare workers at Little Goslings, Tillicum, Lilliput, Morningside, Kinderclub, and Kids Club "shared in the caring," so I could have time, and peace of mind; And last, first, always—Jerome weathered it all, despite it all, so I could have it all. Thank you. ix OFFERING TO THE MUSES I DEDICATION I dedicate this work to those who are to either
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