The pragmatics of therapeutic interaction: An empirical study

Abstract

The research reported in this article aims to demonstrate a method for the systematic study of the therapist/patient interaction in psychoanalytic psychotherapy, drawing upon the tradition and methods of 'pragmatics'--the study of language in interaction. A brief introduction to the discipline of pragmatics demonstrates its relevance to the contemporary focus of clinical theory on the here-and-now dynamics of the relationship between analyst and patient. This is followed by a detailed study of five segments from the transcript of a therapeutic dialogue, drawn from a brief psychoanalytic psychotherapy, in which therapist and patient negotiate the meaning of the patient's symptom: Is it psychosomatic? The research seeks to show how the therapeutic process can be observed and studied as an interactional achievement, grounded in general and well-studied procedures through which meaning is intersubjectively developed and shared. Implications of the analysis for clinical theory and practice, and further research, are discussed.

Rhythm and blues – Amalie's 152nd session: From psychoanalysis to conversation and metaphor analysis – and back again

“…This accent on ‘doing transference’, ‘doing projective identification’ etc. is close to Roy Schafers ‘action language’, it is close to the generic insight that by talking something is done in treatment, that words are not only representations but pragmatic actions (Lepper, ). ‘How’ something is ‘done’ by words was described in interesting details for anxiety disorders (Capps and Ochs, ) and for anorexia disorder (Hepworth, ).…”

“…Lepper () proposed to make psychoanalysis an observational science with an eye for the details of conversation. This is no behavioral or behavioristic orientation!…”

“…The analysis of the recording shows that the analytic surface (Krejci, ; Levy and Inderbitzin, ; Spence et al ., ) entails precisely all the elements needed for analysis. The methodological step that could make psychoanalysis an observational science (Lepper, ) is not to look behind the surface but onto the surface. The patient's conflict shows up on the surface, her defense, too and the way she suffers.…”

“…'How' something is 'done' by words was described in interesting details for anxiety disorders (Capps and Ochs, 1995) and for anorexia disorder (Hepworth, 1999). Lepper (2009) proposed to make psychoanalysis an observational science with an eye for the details of conversation. This is no behavioral or behavioristic orientation!…”

The Building of Empathy: Conceptual “Pillars” and Conversational Practices in Psychotherapy

“…Using the "empiricism of conversation" (in the form of transcriptions of genuine therapeutic conversations), we expect to be able to provide a clearer description of how empathy is created. This forms part of an attempt to re-establish psychoanalysis as an observational science [30]. Psychoanalysis can look back on an "empiricism of conversation" without recourse to other methods and empiricisms that might be considered quite foreign.…”