From pain to self-awareness--a qualitative analysis of the significance of group participation for persons with chronic musculoskeletal pain.

The experiences of persons with chronic musculoskeletal pain who participated in a twelve-session process and experience-oriented learning programme were analysed with qualitative methods. The programme was based on a phenomenological frame of understanding where the individual's experience of her/his situation was essential. The educational approach was inspired by personal construct theory that calls attention to the human being's capacity to redefine and reconstruct the meanings of any situation and symptom. Certain qualities and values were embedded in the group programme: A context that emphasised an understanding of the body 'as a talking subject' rather than focusing on pain and diagnoses; the wholeness of participants' situation rather than viewing chronic muscular pain as either physical or psychological: activity, participation and operating within the participants' everyday language and ways of expressing themselves; respecting, seeing, listening and trusting the group participants; focusing on each participant's and the whole group's resources, potentials and possibilities; challenging the participants to evoke their inner authority and internal validation instead of surrendering authority on their pain to the health personnel. Self-reports shortly after, and a year after, participation indicated that participants in the groups had reconstructed some patterns in their lives, both in relation to self and others. They had an increased awareness of self, less pain and more constructive ways of handling pain and life situation.