Cultural ideas about language, and how it should be spoken by those who are suffering, radically impact people's experiences in clinical institutions. Forging ties between linguistic, medical, and organizational anthropology, this study centers on conventions of speaking in an outpatient drug treatment program for homeless women. Premised on three years of ethnographic research, I document the clinical processes by which clients learned what they could legitimately say about themselves, their circumstances, and their institutional surrounds. My work demonstrates that the program's clinical regimen was grounded in particular ideology of language---that is, the ideology of inner reference---which presumes that healthy talk is an easy, unfettered reflection of its speakers. And while therapists invested in the language of inner reference as an antidote to addiction, this study identifies some of harmful effects of this language on those that the program intended to help. For example, I argue that by prescribing highly personalized ways of speaking, the program hindered clients' ability to critique and challenge institutional practices. Attentive also to the high stakes of talk therapy, I show that a client who adhered to clinical scripts was deemed within reach of the clean and stable self toward which all drug treatment is aimed. This therapeutic reward was tied to the promise of release from the program, return of children from the state, or fulfillment of parole---practical goals to which all clients could relate. Not surprisingly, then, clients strove to decipher the conditions within which they spoke and linguistically maneuver within them. Seasoned clients came to practice the art of what they called flipping the script---spinning a convincingly personalized narrative of willful recovery so as to camouflage a recent relapse or obscure a weekend binge from program staff. Strategically reproducing rather than explicitly resisting the language of inner reference, script-flippers learned that a clean tale, much like a clean screen, would help them garner needed services and avoid institutional sanction. However, in the end, this study demonstrates that flipped scripts, like followed ones, are rooted as much in dynamic opportunities in time and space as they are in narrators' psyches.Ph.D.Cultural anthropologyLanguage, Literature and LinguisticsLinguisticsSocial SciencesSocial workUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/124373/2/3138124.pd
