Displaying agency problems at the outset of psychotherapy

Abstract

In order to present him-or herself at the outset of psychotherapy as a credible client, the person needs to, on one hand, formulate a sense of lost agency in accounts of his/her life situation, and on the other, to present him-or herself as willing and able to take part in conversational selfexploration. In this study we looked in detail at how one person, seeking psychotherapy, constructed accounts that served this double function. We sought to develop the usefulness of the concept of agency as an integrative theoretical construct of core processes in therapy and introduced a model of five aspects of agentic vs. non-agentic presentation, developed and applied in an earlier study on clients in semi-mandatory counselling. The results show how those aspects -relationality, causal attribution, intentionality, historicity, and reflexivity -were present in, or lacking from, accounts given by this one client entering voluntary psychotherapy. We conclude that qualitative process research could benefit from considering loss of agency as one crucial object of psychotherapy and the ongoing discursive formulations and re-formulations of the client's more or less agentic positions as central to the process of therapy.

Constructions of Nonagency in the Clients’ Initial Problem Formulations at the Outset of Psychotherapy

“…Problem construction entails situational and discursive positioning in a context where problem talk is expected and invited (Buttny 2004;Wahlström and Seilonen 2016). Positioning refers to how people in situated talk take a stance in relation to aspects of their experience and life events, thereby creating different positions for themselves and others (Davies and Harré 1990;Wahlström 2016).…”

“…In the first session of psychotherapy, clients are expected to indicate a need for help with something constructed as a problem (Wahlström and Seilonen 2016), hence, describe situations where they either do not initiate actions they wish to, or where they undertake actions not expected nor wished for by themselves (Wahlström 2006). In these descriptions, the clients adopt nonagentic positions, that is, stances where the speaker's possibilities to influence situations are depicted as reduced in respect to some aspects of one's life, situation, experiences, or actions (Wahlström 2016).…”

“…Displaying nonagency entails both referring to the substance (i.e., the clients' actual experience of having lost agency in their lives) and the process of psychotherapy (i.e., the seeking of a position in the situational context). The experience of lost agency is not reduced to a mere linguistic presentation, but our aim is to examine how clients achieve the institutionally framed objective of presenting themselves as having problems and hence, being in a nonagentic position (Wahlström and Seilonen 2016).…”

Changes in the sense of agency: Implications for the psychotherapy of bulimia nervosa‐ A case study

“…There is as a focus in both approaches on maladaptive thought processes and behaviors, as well as on psychoeducation. The main difference is that the current model focuses on painful emotional experiences and themes that arise in different phases of a patientʼs Mackrill (2009) and Wahlström and Seilonen (2016) s sense of agency. These experiences are often barriers to behavioral change.…”

Constructing Nonagency at the Beginning of Psychotherapy: The 10DT model

“…Discursively, clients may display what has been coined "agentless talk" by speaking about their unwished-for experiences and actions as just happening to them, thus taking the position of the receiver of their own experiences, or about their present actions as having followed some particular rule or as being the effect of some causal process (Kurri & Wahlström, 2007). According to Wahlström and Seilonen (2016), loss of agency is on one hand an actual state of affairs in a person's life, and on the other hand a discursive presentation or display of oneself as being in a non-agentic position.…”