Depression, Rational Identity and the Educational Imperative: Concordance-Finding in Tricky Diagnostic Moments

It is well-documented, within most medical and much health psychology, that many individuals find diagnoses of depression confusing or even objectionable. Within a corpus of research and practical clinical guidance dominated by the social-cognitive paradigm, the explanation for resistance to a depression diagnosis (or advice pertaining to it) within specific interactions is bordering on the canonical; patients misunderstand depression itself, often as an output of an associated social stigma that distorts public knowledge. The best way to overcome corollary resistance in situ is, logically thus, taken to be a clarification of the true (clinical) nature of depression. In this paper, exploring the diagnosis of depression in UK primary care contexts, the social-cognitive position embedded in contemporary medical reasoning around this matter is critically addressed. It is firstly highlighted how, even in a great deal of extant public health research, the link between an individual holding “correct” medical knowledge and being actively compliant with it is far from inevitable. Secondly, and with respect to concerns around direct communication in clinical contexts, a body of research emergent of Discursive Psychology and Conversation Analysis is explored so as to shed light on how non-cognitive concerns (not least those around the local interactional management of a patient’s social identity) that can inform the manner in which ostensibly “tricky” medical talk plays-out in practice, especially in cases where a mental illness is at stake. Finally, observations are drawn together in a formal Discursive Psychological analysis of a small but highly illustrative sample of three cases where a depression diagnosis is initially questioned or disputed by a patient in primary care but, following further in-consultation activity, concordance with the diagnosis is ultimately reached—a specific issue hitherto unaddressed in either DP or CA fields. These cases specifically reveal the coordinative attention of interlocutors to immediate concerns regarding how the patient might maintain a sense of being an everyday and rational witness to their own lives; indeed, the very act of challenging the diagnosis emerges as a means by which a patient can open up conversational space within the consultation to address such issues. While the veracity of the social-cognitive model is not deemed to be without foundation herein, it is concluded that attention to local interactional concerns might firstly be accorded, such that the practical social concerns and skills of practitioners and patients alike might not be overlooked in the endeavour to produce generally applicable theories

Persuasive Conduct: Alignment and Resistance in Prospecting “Cold” Calls

Social psychology has theorized the cognitive processes underlying persuasion, without considering its interactional infrastructure – the discursive actions through which persuasion is accomplished interactionally. Our paper aims to fill this gap, by using Discursive Psychology and Conversation Analysis to examine 153 ‘cold’ calls, in which salespeople seek to secure meetings with prospective clients. We identify two sets of communicative practices that comprise persuasive conduct: (1) pre-expanding the meeting request with accounts that secure prospects’ alignment to this course of action without disclosing its end-result and (2) minimizing the imposition of the meeting to reduce the prospect’s opportunities for refusal. We conclude that persuasive conduct consists in managing the recipiency of the meeting requests by promoting alignment and hampering resistance. Overall, this paper contributes to the wider discursive psychological project of ‘respecifying’ psychological phenomena like attitudes, memory, and emotion from the realm of social cognition to the realm of social interaction

Vocabularies of social influence: Managing the moral accountability of influencing another

While there are many definitions and conceptual accounts of ‘persuasion’ and other forms of social influence, social scientists lack empirical insight into how and when people actually use terms like ‘persuade’, ‘convince’, ‘change somebody's mind’ – what we call the vocabularies of social influence – in actual social interaction. We collected instances of the spontaneous use of these and other social influence terms (such as ‘schmoozing’ and ‘hoodwinking’) in face‐to‐face and telephone conversations across multiple domestic and institutional settings. The recorded data were transcribed and analysed using discursive psychology and conversation analysis with a focus on the actions accomplished in and through the use of social influence terms. We found that when speakers use 'persuading' – but not 'convincing' or 'changing somebody’s mind' – it is in the service of orienting to the moral accountability of influencing others. The specificity with which social actors deploy these terms demonstrates the continued importance of developing our understandings of the meaning of words – especially psychological ones – via their vernacular use by ordinary people in the first instance, rather than have psychologists reify, operationalize, and build an architecture for social psychology without paying attention to what people actually do with the ‘psychological thesaurus’

How to increase participation in a conflict resolution process: Insights from discursive psychology

In this chapter, I will explore the mediation of neighbour and family conflicts through the lens of discursive psychology, focusing particularly on what interaction between mediators and their prospective clients (neighbours, parents) tells us about the nature of dispute and the efficacy of mediation. I will describe a research project, from its inception studying neighbour disputes to its culmination in training mediators to better engage prospective mediation clients. The chapter will start by locating this project in the wider fields of mediation, neighbour and family disputes, as well as discursive and interactional work on conflict in interaction. I will describe the collection of large-scale qualitative datasets, including telephone calls to mediation services, environmental health services, and police interviews with arrested suspects in neighbour and family conflict cases. These data were analysed using conversation analysis, in the discursive psychological tradition pioneered by Edwards (e.g., 2005) and Potter (e.g., Potter & Hepburn, 2007). I will show how mediators fail and succeed to attract potential clients to mediation, and how small changes to the way mediation is explained, and how resistant clients may be persuaded to mediate, can be identified by the analysis of interaction. Finally, I describe how research findings about what works to engage clients has underpinned national and international mediation training, using the Conversation Analytic Role-play Method. In sum, the chapter will show how discursive psychological research can have big pay-offs in terms of the impact of its findings in real life settings that matter for people in conflict