Narrative Medicine and TKM Music Therapy in Parkinson’s Disease

다국어 초록 (Multilingual Abstract)

Objectives
Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. In addition to motor symptoms such as tremor, bradykinesia, rigidity, and postural instability, patients often experience a wide range of non-motor symptoms including depression, anxiety, apathy, sleep disturbances, and autonomic dysfunction. With projections indicating that 20.6% of the South Korean population will be aged 65 or older by 2025 (Statistics Korea), there is increasing attention on Parkinson’s disease as the country transitions into an ageing society.
Traditional Korean Medicine (TKM) approaches the human being from a mind–body integrative perspective, recognising disease not merely as a biological abnormality but as a holistic issue encompassing an individual’s life story. Within this framework, the present study explores the potential of music therapy—a component of traditional Korean psychological treatment—as a medium for restoring the identity and internal narrative of individual patients with Parkinson’s disease.
Narrative Medicine expands the therapeutic context by centring the patient’s story, emphasising the process through which patients give meaning to their illness experiences and reconstruct their sense of self. This study adopts a narrative medicine perspective to investigate the impact of music therapy on the psychological and emotional recovery of patients with Parkinson’s disease, aiming to provide evidence for complementary and alternative approaches in PD treatment.
Methods
This case study involved four adult out-patients diagnosed with Parkinson’s disease. A 24-week music therapy programme was conducted, with changes before and after the intervention observed and analysed. Therapy sessions were held once a week, lasting 40–60 minutes, and included breathing exercises, singing, movement, and improvisational vocalisation. Quantitative and qualitative changes were assessed using the General Self-Efficacy Scale (GSE), EQ-5D, EQ-VAS, observational records, and patient narratives.
Results
Following 24 weeks of music therapy, all participants demonstrated increased scores in self-efficacy (GSE). In particular, one patient who had experienced severe panic attacks and speech inhibition continued to benefit emotionally from breathing exercises even after the programme had ended. During the later sessions, the patient began to choose songs independently and performed on stage. This behaviour reflected improved communication abilities, greater self-expression, and a renewed sense of self-esteem. For this individual, music became a means of rearticulating a personal narrative that had been disrupted by Parkinson’s disease.
Conversely, one participant with severe depression experienced a worsening of symptoms post-treatment and required psychiatric care. However, her regular participation and interactions with other patients during the therapy period appeared to have a temporary positive effect on her depressive symptoms, underscoring the therapeutic value of consistent social interaction.
Conclusion
Music therapy offers therapeutic potential not only for improving physical function in patients with Parkinson’s disease, but also for fostering emotional recovery, enhancing self-efficacy, and reconstructing the personal narrative. The narrative medicine approach allows patients to re-interpret meaning of their illness and re-establish emotional connections with others—valuable psychosocial resources in managing Parkinson’s disease. This study suggests that music therapy may function as a therapeutic language aiding in the restoration of the self. Future clinical research should incorporate larger sample sizes and multidisciplinary collaboration to further substantiate these findings.
A key limitation of this study is the small sample size, involving only four participants over the 24-week period. Moreover, as all participants concurrently received herbal medicine, acupuncture, antidepressants, and anti-Parkinsonian medications, it is difficult to attribute observed outcomes solely to the music therapy intervention. Further research involving larger cohorts is necessary to more clearly delineate the specific effects of music therapy in this context.

목차 (Table of Contents)

• Table of Contents ⅰ
• List of Tables ⅲ
• Ⅰ. Introduction 01
• 1. Background 01
• 2. Music Therapy in TKM 02
• Ⅱ. Methods 05
• 1. Treatment Structure 05
• 2. Participants 06
• 3. Evaluation 07
• Ⅲ. Results & Discussion 10
• 1. Case I 10
• 1) Patient Information 10
• 2) Changes During Therapy 10
• 3) Qualitative Interpretation 12
• 2. Case Ⅱ 13
• 1) Patient Information 13
• 2) Changes During Therapy 14
• 3) Qualitative Interpretation 16
• 3. Case Ⅲ 18
• 1) Patient Information 18
• 2) Changes During Therapy 18
• 3) Qualitative Interpretation 21
• 4. Case IV 23
• 1) Patient Information 23
• 2) Changes During Therapy 24
• 3) Qualitative Interpretation 27
• Ⅳ. Conclusion and Recommendations 28
• References 31
• Abstract in Korean 35