Practices of Claiming Control and Independence in Couple Therapy With Narcissism

Abstract

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.

Spectrum of complaints: practices of complaining in therapeutic conversations as a window to spouses' personalities and couples' relationships

“…The data analysis initially involved unmotivated exploration aimed at recognizing interactional practices in couples with or without personality disorders. This led to more focused work on phenomena such as "controlling the interaction" (Janusz et al, 2021) and "disengagement in the interaction" (Peräkylä et al, 2023). The current project was focused on complaining practices.…”

“…To get a deeper understanding of complaining practices in couple therapy, a more sophisticated observational perspective is called for. As we have done in earlier research (Janusz et al, 2021;Peräkylä et al, 2023), we adopt a conversation analytic approach which enables us to identify conversational details of complaining activities as well as sequences in which clients prepare and deliver a complaint or respond to it. A conversation analytic perspective on complaining practices in marital therapy is justified because complaints, accusations, and similar ways in which interlocutors deal in everyday life with a deemed wrongdoing are a prominent topic within that research tradition.…”

Strategic use of observer-perspective questions in couples therapy

“…CA-based research takes a complementary perspective and focuses on how important events in therapy unfold in “talk therapy”; how these interventions are realized and made effective. For the most part, the focus of these CA investigations in CT and FT has been on the therapeutic alliance (Muntigl and Horvath, 2016 ), therapist-client collaboration (Sutherland and Strong, 2011 ), resistance (Muntigl, 2013 ), so-called “change moments” (Couture, 2006 , 2007 ), therapeutic agendas (Gale, 1991 ), spouses claiming independence and control (Janusz et al, 2021 ), ascriptions of blame (Buttny, 1993 ; Edwards, 1995 ), client complaints (O'Reilly, 2005 ; Peräkylä et al, 2023 ), and the familial moral order (Hutchby and O'Reilly, 2010 ; Wahlström, 2016 ). A “critical methodological review” arguing for the benefits of using CA to study family therapy is given by Tseliou ( 2013 ).…”

“…. (Muntigl and Horvath, 2016), therapist-client collaboration (Sutherland and Strong, 2011), resistance (Muntigl, 2013), socalled "change moments" (Couture, 2006(Couture, , 2007, therapeutic agendas (Gale, 1991), spouses claiming independence and control (Janusz et al, 2021), ascriptions of blame (Buttny, 1993;Edwards, 1995), client complaints (O'Reilly, 2005Peräkylä et al, 2023), and the familial moral order (Hutchby and O'Reilly, 2010;Wahlström, 2016). A "critical methodological review" arguing for the benefits of using CA to study family therapy is given by Tseliou (2013).…”

“The Poorer the Sicker, and Vice Versa?” Mapping the Sociological Research on Mental Health and Illness

“…Finally, just to complete the picture, I would like to add a fifth form of reasoning: The broad ethnomethodological and conversation analytic research tradition that is unfortunately not mentioned in Explaining Mental Illness , probably for systematic reasons. Studies in this tradition cover a broad scope of research: Garfinkel's (1984:208) work on social selection procedures in a psychiatric outpatient clinic but also conversation analytic research on the interaction between professionals and (potential) patients or clients (Janusz et al 2020). Ethnomethodology and conversation analysis with their special focus on the ways of working in health care organizations, form another piece of the puzzle for a broader understanding of the thoroughly social foundation of mental health and illness.…”