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Starting points for therapeutic change: Therapists’ rewordings of patients’ experiences

Issue: Vol 16 No. 2 (2019) Special Issue: Understanding Change in Psychotherapy

Journal: Communication & Medicine

Subject Areas: Healthcare Communication Linguistics

DOI: 10.1558/cam.33827


Based on a corpus of 70 tape-recorded therapy sessions (client-centered therapy, psychodynamic therapy), this paper presents analyses of therapists’ interventions that have the potential to trigger change processes. Using a conversation analytic approach, we identify utterances that re-formulate the patient’s experience from a different perspective. In a second step, we draw on concepts from cognitive and pragmatic linguistics, mainly “frame” and “category”, to analyze the conceptual side of these rewordings. We show that, besides processes of general abstraction, the conceptualization of the patient’s experience from a societal perspective is a crucial part of the rewordings. The verbal re-framing creates a potential for accessing stocks of societal knowledge that would not have been accessible based on the patient’s initial, individualistic and often erratic presentation of events. By changing the wording an experience is referred to, the therapist thus creates links to established collective knowledge about experiences of this category. Once such links to collective knowledge have been created, it then becomes possible to understand differently how the experience in question came to pass, which features it is characterized by and how it can be dealt with in a way that is collectively known to be helpful.

Author: Claudio Scarvaglieri

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