APPEALING TO THE EXPERIENCE OF THE PATIENT IN THE CARE OF THE DYING

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Two traditions of interaction research

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Making links in psychoanalytic interpretations: A conversation analytical perspective

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Conversation analysis: a new model of research in doctor patient communication

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Experience sharing, emotional reciprocity, and turn-taking

In this perspective article, we consider the relationship between experience sharing and turn-taking. There is much evidence suggesting that human social interaction is permeated by two temporal organizations: (1) the sequential framework of turn-taking and (2) the concurrent framework of emotional reciprocity. From this perspective, we introduce two alternative hypotheses about how the relationship between experience sharing and turn-taking could be viewed. According to the first hypothesis, the home environment of experience sharing is in the concurrent framework of emotional reciprocity, while the motivation to share experiences is in tension with the sequential framework of turn-taking. According to the second hypothesis, people's inclination to coordinate their actions in terms of turn-taking is motivated precisely by their propensity to share experiences. We consider theoretical and empirical ideas in favor of both of these hypotheses and discuss their implications for future research.Peer reviewe

Practices of Claiming Control and Independence in Couple Therapy With Narcissism

Four couple therapy first consultations involving clients with diagnosed narcissistic problems were examined. A sociologically enriched and broadened concept of narcissistic disorder was worked out based on Goffman's micro-sociology of the self. Conversation analytic methods were used to study in detail episodes in which clients resist to answer a therapist's question, block or dominate the development of the conversation's topic, or conspicuously display their interactional independence. These activities are interpreted as a pattern of controlling practices that were prompted by threats that the first couple therapy consultation imposes upon the clients' self-image. The results were discussed in the light of contemporary psychiatric discussions of narcissism; the authors suggest that beyond its conceptualization as a personality disorder, narcissism should be understood as a pattern of interactional practices.Peer reviewe

Empathy, Challenge, and Psychophysiological Activation in Therapist-Client Interaction

Two central dimensions in psychotherapeutic work are a therapist's empathy with clients and challenging their judgments. We investigated how they influence psychophysiological responses in the participants. Data were from psychodynamic therapy sessions, 24 sessions from 5 dyads, from which 694 therapist's interventions were coded. Heart rate and electrodermal activity (EDA) of the participants were used to index emotional arousal. Facial muscle activity (electromyography) was used to index positive and negative emotional facial expressions. Electrophysiological data were analyzed in two time frames: (a) during the therapists' interventions and (b) across the whole psychotherapy session. Both empathy and challenge had an effect on psychophysiological responses in the participants. Therapists' empathy decreased clients' and increased their own EDA across the session. Therapists' challenge increased their own EDA in response to the interventions, but not across the sessions. Clients, on the other hand, did not respond to challenges during interventions, but challenges tended to increase EDA across a session. Furthermore, there was an interaction effect between empathy and challenge. Heart rate decreased and positive facial expressions increased in sessions where empathy and challenge were coupled, i.e., the amount of both empathy and challenge was either high or low. This suggests that these two variables work together. The results highlight the therapeutic functions and interrelation of empathy and challenge, and in line with the dyadic system theory by Beebe and Lachmann (2002), the systemic linkage between interactional expression and individual regulation of emotion.Peer reviewe

The paradox of disengagement : Bodily displays of inattention in couple therapy

Using concepts developed by Goffman and the theory of inter-corporeality, this paper describes non-speaking spouses' responses to complaints made about them by the other spouse in the context of couple therapy first consultations. While the turn-taking system of couple therapy effectively precludes the possibility of a direct verbal response, non-speaking spouses often display bodily their disengagement from their spouse's talk. Using multimodal conversation analysis as the method, we show the repertoire of such disengagement behaviors and trace the moment-by-moment contexts in which they arise. While disengagement behaviors embody their producer's inattention to their spouse's talk, at the same time, they are, paradoxically, interactional moves produced in the presence of others, conveying their producer's negative stance to the ongoing talk. We argue that the timing of these disengagement practices involves anticipation of the direction of talk: non-speaking spouses display disengagement in moments when the speaking spouse's talk takes a direction toward an intensification of complaints about them.Peer reviewe

Does the delivery of diagnostic news affect the likelihood of whether or not patients ask questions about the results? A conversation analytic study

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.This paper was produced following a collaboration between researchers at Imperial College London, University of Leicester and De Montfort University

Affective stance, ambivalence, and psychophysiological responses during conversational storytelling

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