Treating arthritis and lupus patients with music-mediated imagery and group psychotherapy

Abstract

The authors of this article conducted an empirical study of the effectiveness of music-mediated imagery and group psychotherapy on the behavioral functioning of arthritis and lupus patients. A second focus centered on the interaction between imagery and psychotherapy. Imagery and visualization are rapidly becoming exploited techniques in the current “New Age” music market. Many patients become discouraged with relaxation and imagery tapes when experienced guides or therapists do not assist the process. Whether music-mediated imagery alone or in combination with psychotherapy is a potent stimulus in facilitating relaxation and pain/disease management in patients with chronic disease is an important research question for which the answer was sought. Research in the field of music therapy has confirmed that music can facilitate relaxation as measured through the physiological parameters of electromyography (EMG) (Rider, 1985; Scartelli, 1984; Sears, 1958), electroencephalography (EEG) (Borling, 1981; Wagner, 1975), galvanic skin resistance (GSR) (Peretti, 1983; Zimny & Weidenfeller, 1963) finger temperature (Kibler & Rider, 1983), and pain threshold (Rider, 1985). In a study of the effects of music-mediated imagery and relaxation, Rider, Floyd and Kirkpatrick (1985) found a re-entrainment of circadian rhythms in shiftworkers and a significant decline in the circadian amplitude of adrenal corticosteroids. Chronic elevations of corticosteroids are thought to inhibit various components of the immune response (Monjan, 1981; Palmblad, 1981). In their review of the subject, Ader and Cohen (1984) report an association between repression (particularly of anger) and the autoimmune diseases, of which rheumatoid arthritis and systemic lupus erythematosus are two. It was further suggested by Ader and Cohen that the psychophysiological mechanism responsible for the immunosuppressive effects of emotional repression involves the hyper-stimulation of the hypothalamus-pituitary-adrenal axis leading to the production of immunoglobulins directed at the body’s own organs. Luthe (1983) has indicated that autogenicallystimulated imagery of medical patients often follows a developmental course as long as the therapist is nondirective and the patient becomes a “passive observer” of his or her own imagery. This technique of “autogenic abreaction” eventually leads to insight, catharsis, and a shift in imagery toward multichromaticism (color), increasing complexity, and active participation (Luthe, 1983). These imagery changes generally concur with medical and psychological improvement. Simonton, Simonton and Creighton (1978) and their colleagues, Achterberg and Lawlis (1980), have developed chronic disease treatment programs utilizing imagery of both patients’ medical treatment and self-generated bodily defenses in restoring health. Psychotherapeutic processing of uncomfortable images and other emotional and cognitive issues related to the patients’ diseases became a major ingredient of disease and pain management. Such health outcomes