“The Pressure” is a multimedia work for a large ensemble of instrumentalists, singers, narrator, MIDI controlled Disklavier (player piano), and illustrations. The music is composed by Brian Baumbusch, set to a story written by Paul Baumbusch and with illustrations created by Federico Yankelevich; the work is based on themes of German expressionist silent films. This thesis presents the score to “The Pressure,” as well as an analysis of the music and the creative development behind the work.