Despite advances in medical technology, the patients' history remains the most crucial tool in the differential diagnosis of epileptic or non-epileptic seizures (NES). The distinction of these two types of seizures is a common and important task for neurologists. Whereas epileptic seizures would be treated with antiepileptic drugs, non-epileptic seizures are thought to be a manifestation of psychological or social distress and can improve with psychotherapy. This paper summarizes the findings of a series of multidisciplinary research studies undertaken at the Bethel Epilepsy Centre and the University of Bielefeld in Germany in which linguistic analysis was carried out to identify and describe linguistic and interactional features in clinical exchanges between doctors and patients with seizures. Two distinct communication profiles emerged in these studies based on the analysis of transcripts of over 110 doctor-patient encounters. Epileptic seizure descriptions are characterized by formulation effort, provide the doctor with a coherent account of individual seizures, relate subjective seizure experiences and use consistent metaphoric conceptualizations. Patients with NES tend not to volunteer subjective seizure symptoms, give accounts of their seizures which are difficult to understand and are inconsistent in their choice of metaphors.
A B S T R AC T Unlike a great deal of research on expert/non-expert communication, most of which is based on written materials, this article focuses on face-to-face communication. The analysis is based on a large corpus of transcribed recordings of medical seminars in rehabilitation centres and of interviews with chronically ill patients suffering from heart conditions. The focus is on procedures of illustration, which are often combined with reformulation procedures. Four main types are described: metaphors, exemplification, 'scenarios', concretization. Whatever the type of illustration used, participants in face-to-face interaction show a marked preference for procedures which relate abstract medical information to everyday life and experience.After a brief outline of the theoretical approach adopted the analysis proceeds in two steps: first, the emphasis is on techniques employed by the 'experts', then on those used by 'non-experts', i.e. patients. This is followed by an examination of the question how the roles of expert and non-expert are constituted in and by interaction.
L'analyse proposée par cet article s'inspire à la fois de la linguistique textuelle allemande et de l'analyse conversationnelle des ethnométhodologues américains. Se basant sur un corpus de conversations authentiques, recueillies en 'situations de contact' entre interlocuteurs français et allemands, elle concerne des énoncés qui sont présentés et/ou traités comme inachevés par les interlocuteurs. On décrit l'organisation séquentielle de l'énoncé inachevé du locuteur non-natif et celle de son achèvement interactif, accompli par le locuteur natif. Si le locuteur non-natif, par suite d'une difficulté de formulation, n'est pas capable d'achever son énoncé, il dispose quand même de certaines 'méthodes' pour solliciter l'aide de son interlocuteur et pour indiquer à celui-ci en quelque sorte une 'direction de recherche'. L'effort coopératif des partenaires mène ainsi à une 'co-construction' du discours.
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