Reading between the lines in psychotherapy.  Conversation Analysis and Intersubjectivity.  A single case study


Maurizio Viaroa, Fabrizio Bercellib & Federico Rossanoc

a European Institute of Systemic Therapies, Milan, Italy

 b University of Bologna, Italy                             

 cDepartment of Cognitive Science, University of California, San Diego (USA)

 

Abstract

 


In this single case study, we investigate an interactive episode involving a typical Freudian slip by a patient during a session in an individual systemic treatment. We use Conversation Analysis (CA) to provide a preliminary empirical account of the repair sequence ensuing the slip.

 This initial step allows us to analyze the implicit and interpersonal dimension of the interaction subsequently. Selected passages from the succeeding sessions provide further conversational evidence of our interpretations. We consider the whole constellation of the episodes as a unitary manoeuvre carried out via three successive steps. CA provides a powerful tool, independent from the theory of the therapists, to empirically explore the implicit intersubjective dimension, where critical interactive phenomena occur.

 

Keywords: Conversation Analysis, Intersubjectivity; Systemic therapy; Freudian slip

Peräkylä and Vehvilainen (2003) demonstrated the advantages of applying Conversation Analysis (CA) to the study of psychotherapy and counselling[1]. In psychotherapy, "the main contribution of CA turns out to be that of showing how a particular task or activity (…) is carried out (…) and to explicate the interactional dynamics of the devices used in that context" (Peräkylä and Vehvilainen, 2008: 23).

However, a significant gap remains between what experienced clinicians do with their patients in the sessions and what conversation analytic researchers say about therapy interaction. Clinicians can hardly manage to attach a therapeutic meaning to CA findings and seem to feel that the timeconsuming work of transcribing the minutiae of interaction required by CA conventions is a technicality with reduced therapeutic import. So far, CA studies of therapy interactions have failed to contribute substantially to both clinical practice and training. Most practitioners feel that CA researchers prioritize academic needs over clinician-client ones (Madill et al., 2001).  In this paper, we aim to show the potential of Conversation Analysis in the exploration of the intersubjective dimension and its clinical importance as well. In this single-case study, we focus on the elaboration process of an unwanted, unplanned event like a typical 'Freudian slip' is, in individual systemic therapy. Let us first introduce the theoretical frame.

 

The Theoretical Frame

Intersubjectivity

Intersubjectivity is a crucial concept in phenomenology, social constructionism and symbolic interactionism. Although there is no full consensus on how exactly this concept is to be defined, we can assume here that, in the simplest terms, Intersubjectivity is the sharing of experiential content (e.g. intentions, feelings, perceptions, thoughts, memories) between at least two subjects. 

In developmental psychology, Trevarthen (1979) premiered this concept which has assumed outstanding importance in Infant Research.  Beebe (2014), Stern (2004) and the Boston Change Process Study Group (BCPSG, 2010) translated these methods and concept into psychoanalysis.

Of course, a model derived from infant research cannot be directly translated into the adult psychotherapy.  However, its method can be applied to whatever kind of psychotherapy treatment as it is centred entirely on the process of interaction, independently from any psychological theory. The focus is on implicit communication and patterns of expectation between therapist and patient as therapeutic actions. This kind of action does not need to be translated into words.

Stern (2004: 171), the BCPSG (2010) and Ammanniti, Gallese (2014) hypothesise that the mirror neuron system provides the neurobiological basis for Intersubjectivity.

 

Conversation Analysis

The term ‘conversation’ is often used in systemic therapy, although in various meanings. In this paper, we use this word as used in Conversation Analysis (CA) to denote “talk-in-interaction” (Sacks, 1974; Schegloff, 2007; Sidnell & Stivers, 2012).  CA is an empirical, qualitative, and inductive method to analyze documented natural interaction (audio and video recordings). Its paradigm assumes the participants build their interaction orderly and aims to reveal the orderly structures of social interaction. 

“Turn-taking” is the first obvious level of organization in a verbal exchange. In CA, however, the key units are the actions; even remaining silent, when responding would be relevant, can be considered an action (Schegloff, 1996; 2007). The type of action occurring at a given moment is understood by how the participants respond to it. For example, asking a question is recognized as such because an answer follows; if the answerer misunderstood, the first speaker launches a repair sequence to clarify his/her previous intention.  Hence, a question is considered the ‘first pair part’ of the adjacency pair question-answer and a synonym for sequence of interaction. Each segment of speech the speaker uses to carry out an action in his/her turn-at-talk is called a Turn Construction Unit (TCU). There may be more than one TCU in a turn-at-talk (a multi-unit turn). The end of a TCU, called a transition relevance place (TRP), is a point where another speaker can take a turn, or the present speaker may continue with another TCU (Sacks, Schegloff, Jefferson, 1974).

 

Data & Method

Our data consists of transcribed audio recordings of 14 sessions at the beginning of an individual systemic treatment. The entire therapy comprised of 28 sessions. The patient, whom we will call “Pia,” is a 31-year-old married woman with no children. The systemic paradigm has been, and currently is (Heatherington et al. 2015), defined by the core concepts of context (taking relationships rather than individuals as the primary unit of analysis), circularity (looking for repeating patterns of behavior), and pattern interruption (identifying and interrupting current interpersonal patterns of problem maintenance).  The hallmark of the individual treatment under scrutiny here is the use of a systemic family model as a guide for individual therapy. Bercelli et al. (2013) applying the CA method to a large corpus of sessions, described this technique as a special kind of conversation. According to these AA., in a session alternate two different types of sequences. In Inquiry sequences, the therapist aims to reconstruct the events during the inter-session period according to a question-answer pattern. The Inquiry sequences occupy the central part of the session. Such sequences alternate with Elaboration sequences, where these same events are commented on and discussed from the point of view proposed by the therapist, a perspective that is different from the patient’s. Alternative behaviours can be suggested or even prescribed by the therapist to the patient, mainly in the last part of the session. Suggesting and prescribing behaviours are peculiar to systemic therapies intending to ‘interrupt interpersonal patterns of problem maintenance’ (Heatherington et al. 2015).

 

 

Method

CA typically requires a large corpus of data. However, there are examples of single CA case-studies (Schegloff 1987; Goodwin 2010) such as our own, and psychotherapy research emphasises the potential of qualitative CA case studies as well (Stiles 2015). 

The episode under scrutiny is a talk sequence around a slip of the tongue – a typical 'Freudian slip' - by the patient. Our analysis is a two-level analysis. The first level involves an examination of the conversational level. We firstly analyse the excerpt containing the slip in purely conversational terms, using CA method. It delves into details at a micro-temporal level, focusing on how the participants deal with the patient's slip of the tongue as a conversational trouble to be ironed out before they can go on with the matter at hand.  We then sort out and analyse at a lesser level of conversational detail the only related passage in the 14 sessions where the Freudian slip episode is recalledThe second level is based on the results of the first. We thus explore at a more interpretative level the implicit and intersubjective dimensions as they emerge from the conversational interaction between the therapist and the patient.

 

The ‘Freudian slip’ Episode as a Repair Sequence

Excerpt 1 Session 3 (The key to the conventions used in the transcript is in the Appendix)

About twenty minutes into the first audio-recorded session, Pia begins to speak about a recent episode in which she felt awkward. She and her husband were having dinner at her father's, along with Pia’s older brother and Pia’s younger sister. Pia explains that her sister-in-law was not at the dinner because she was on holiday but refers to her as “my husband’s wife” instead of “my brother’s wife.” Pia later admitted (omitted here) that her awkwardness was due to her father making a joke, “full of double and triple entendres,” of which Pia thought she was the butt, as everyone laughed and looked at her. Pia joined in the general laughter to hide her embarrassment, as she did not understand the joke and felt ashamed to ask for an explanation.

(P: Pia; T: Therapist)

1 P: qualche giorno fa che ero a XXXX ((nome di città)),

1 P: a few days ago, I was in XXXX ((name of city)),
 

2 è venuto fuori- mio padre (0.2) h ha fatto delle battute

2 it turned out- (0.2) my father (0.2) h made some jokes,

 

3 .h ed eravamo tutti e tre i fratelli a una cena, (0.5)

3 .h and I was at a dinner with my brother and sister, (0.5)

 

4 ee:: senza >la moglie di mio marito, perché era:<=

4 ee:: without >my husband’s wife, because she was:=

 

5 T: =s-=

5 T: =s-=

 

6 P: =in vacanza, (0.2) >quindi lui era a casa< a::=

6 P: =on holiday, (0.2) >so he was at home< a::=

 

7 T: =>°la moglie di suo marito°<

7 T: >°your husband’s wife°<

 

8 (0.8)

 

9 P: eh, sì=

9 P: oh, yes=

 

10 =Oh mio dio=

10 =Oh my god=

 

11 =£di mio fr(h)at(h)ello£ °hh°

11 =£my br(h)oth(h)er’s£ °hh°

 

12 .HH .HH di mio fra(H)t(H)ello

12 .HH .HH my br(H)oth(H)er’s

 

13 T: °°£di suo fratello£°°

13 T: °°£your brother’s£°°

 

14 P: .H HH

14 P: .H .HH
 

15 (1.0)

 

16 P: £(che) lapsu(h)s:£

16 P: £(what a) lapsu(h)s:£
 

17 (0.2)
 

18 £va be’=.hh£

18 £well=.hh£

 

 

19 hh di mio fratello,

19 hh my brother’s,

 

20 era in vacanza (0.8) e mio padre ((la storia continua))

20 she was on holiday (0.8) and my father ((the story continues))

 

After her slip of the tongue, Pia continues to speak (lines 4-6), thus showing she is not aware of it. Then, the therapist initiates the repair sequence[2] by repeating the repairable (line 7), albeit with some delay (2.8 s). Although it is a common way to solicit a repair, repeating a speaker’s previous utterance could also indicate that its listener acknowledged that utterance, thus inviting the speaker to continue (Schegloff, 1996), the former being a disaligned response and the latter an aligned one.

At first, Pia (line 9, “oh, yes”) appears to understand T’s repeat as an aligned response. Immediately after, however, she demonstrates that she realizes her mistake (lines 10-11), with the “oh,” indicating a change in cognitive state (Heritage, 1984). She then emphasizes this by adding “my god.”

Some prosodic features of the therapist’s repetition of her lapsus may have contributed to Pia’s misunderstanding it. The therapist’s words “your husband’s wife” have a pitch contour that differs from Pia’s when she says, “my husband’s wife.” The volume of the therapist’s voice is lower, his rhythm quicker (0.7. instead of 0.9 s), and his pitch sharper. In psychotherapy, lowering the voice is considered a characteristic of therapist intervention aligned with the patient’s previous turn (Weiste & Perakyla, 2014), and this may have led Pia to understand the therapist’s repetition as an aligned response, thus inviting her to continue her storytelling. However, the shift in rhythm, and especially the sharper tone of voice, which Weiste & Perakyla point to as a characteristic of disaligned intervention, sound as though he is challenging what she had just said.

In addition, the truncated “s-” sound (line 5) 0.7” after the lapsus occurred may be a clue that the therapist at first started the repair action, decided to interrupt it, and later changed his mind. Indeed, the “s-” seems to be the start of “scusi?” (“sorry?” in Italian), or of “suo fratello” (“your brother”, words he would go on to say later – line 13), common forms of other-initiated repair. This clue, the contrasting paralinguistic nuances, as well as the delay with which T points out the lapsus, strongly suggest his uncertainty.

Pia seems to perceive T’s discordant hints as she gives no immediate reply (line 8) and then she misunderstands (line 9). It is only soon after that she realizes her misunderstanding (line 10), and, finally, corrects herself (line 11) with a smiley voice and a stifled laugh that is appropriate to the funny nature of the lapsus. Providing the repair could have concluded the repair sequence and enabled Pia to continue with her story. Pia, however, repeats “my brother’s” (line 12), thus expanding the repair sequence. Her repetition of these words is interrupted by noisy bursts of inhaling and exhaling, which is how an extremely embarrassed person acts when unsuccessfully trying to stifle an inappropriate laugh.

Unlike other non-linguistic sounds, e.g., a cough or a sneeze, an uncontrolled laugh is typically linked to what came before and places constraints on what follows. One reaction to an inappropriate laugh would be to ignore it, which sometimes occurs when we are faced with unseemly behavior; pretending not to notice it stigmatizes the behavior only implicitly. Alternatively, we might join in the laughter, an option that usually suggests affiliation and increases the level of intimacy in the relationship (Jefferson, Sacks, Schegloff, 1987). In this case, the therapist repeats (line 13) Pia’s words, but in a similar manner to the first of her two repairs, combining a gentle, smiling tone with a nuance of affability or even tenderness, an emotional state that requires the speaker to lower his/her voice (Anolli, 1992: 366-67). The volume of T’s phrase is even lower than his previous repetition (line 7) of Pia’s words. By lowering his voice even further, the therapist aligns himself with Pia’s first repair (line 10), but not with the second (line 11).

The therapist’s subsequent action (line 13) is even more ‘equivocal’ (Schegloff, 2007, p. 126) than his previous one (line 7). The action could close the repair sequence (Sequence Closing Third), although a closure, per se, is unnecessary as the repair was already completed. This action could be an invitation for Pia to continue her story. Alternatively, this move by the therapist may aim to highlight the lapsus (topicalization) in order to provide Pia with the opportunity to comment on it, or on her embarrassment. Pia understands T’s action as the latter, because she does not continue her story, but instead makes a brief comment suggesting she is aware that her words have major implications (line 16, “what a lapsus”).

What is most noticeable, however, is that Pia seems to expect T to comment, as she offers him three consecutive opportunities to take a turn (TRPs: lines 8, 16 and 17) [A minimal repair sequence consists of two complementary actions (an adjacency pair), where the first pair part is a request for a repair (other-initiated repair) and the second one is the completion of the repair sequence by the speaker responsible for the trouble, who resolves it. A repair sequence may be expanded in many different ways before it is closed, and the previously interrupted course of action is resumed]; opportunities he does not take.

Pia gradually retakes control of her emotions, as she passes from stifled bursts of laughter (lines 12 and 14) to a more composed laughing voice (lines 16 and 18) that is aligned with the therapist’s in line 13. Finally, she returns to her plain narrative tone (lines 1-6) in the third and final repetition of her repair (line 19), which signals that she is about to continue her story.  

On the whole, this repair sequence observes the rules of ordinary conversation. However, it is worth noting how this sequence expands, mainly on Pia’s initiative, as the therapist refrains from commenting.  Pia gives signs of her awareness that something is to be said and of her expectation for the therapist to intervene. In a subtle game of hesitations and mutual expectations, each offers the other the chance to comment and eventually they tacitly agree that ‘this is not the time’.

 

 

Looking into the Intersubjective dimension

 

Let us analyze the same episode at a more interpretative level.

Line 7-9:  the delay and ambiguity with which T points out the lapsus, Pia’s hesitation, her misunderstanding, and her ensuing realization are all initial signs of tension.

Line 10-12: The tension rises and affects their relationship more directly after the repair is repeated the second time, when Pia may have fully understood the possible implications of her lapsus on a relational level. Questions, such as “What is the therapist thinking?” (about Pia’s reaction or the meaning of the lapsus) and “What will he say?” are left unspoken. We could attribute Pia’s embarassment to the fact that her position at that exact moment of the session is like the one she is about to describe, and therefore already has it in her mind, although the therapist is unaware of this at the time. Indeed, her laughter at dinner in front of her father did not stem from shared amusement, but from an attempt to hide her awkwardness and embarrassment, just as it does as she is seated before the therapist.

Line 13: When repeating her words, T uses an intonation contour similar, but not identical, to Pia’s first repair (line 11), ignoring her concern and agitation in her subsequent second repetition of the same words (line 12). From this moment on, Pia’s turmoil decreases.

Line 15: The therapist does not take the opportunity to take the turn and launch an ‘elaboration sequence’ according to the technique (and Pia’s expectation)

Line 16: Pia has regained control, and explicitly shows that she is aware of the possible psychological and relational implications of her lapsus (“what a lapsus”). Both participants now know that the other knows there is more to say.

Line 17: The therapist’s silence is possibly interpreted as a “this is not the time,”

Line 18: Pia’s comment “oh well,” suggests she understood and accepts this. This implicit mutual understanding is an intersubjective event.

Line 19-20: After offering T another brief chance to intervene, Pia repeats the correct repaired phrase in a narrative tone and continues her story, thereby closing the repair sequence.
It is worth noting that the initial tension was resolved with a non-standard action for this technique, with the therapist simply repeating Pia’s most significant words with a similar but not identical intonation contour, so that their meaning is slightly modified.

The implicit dialogue between the therapist and the patient can be understood almost exclusively through the micro-temporal level phenomena that CA systematically denotes in the transcript.  The affective dynamics of this micro-story, sort of a“shared feeling voyage” (Stern 2004, p. 165-176), are expressed by the prosodic variations (e.g., intonation contour, rhythm and volume) that both participants use to repeat the crucial phrase to be repaired and then repaired again.

 

Table 1 summarizes the results of the conversational analysis and clarifies the implicit and intersubjective level. 
 

 

Table 1

TEXT

7          T:   >°my husband’s wife°<

 

8                 (0.8)
 

 

9          P:  well yes

 


10        Oh my god=
 

11  =£my br(h)oth(h)er’s£
 


12 °hh°.HH .HH my
           br(H)oth(H)er’s

 

 

 

 

 

 

13        T:   °°£your brother’s£°°

 

 

14        P:  .HH    
 

15              (1.0)

 

 

16              £(what a) lapsu(h)s:£

 

 

17              (0.2)

 

 

18              £well=.hh£

 

19        hh my brother’s,
 

20              he was on holiday

 

CONVERSATION ANALYSIS

T (therapist) signals a conversational trouble with some delay and contrasting paralinguistic features.

 

P (Pia) is slow to react;

P’s response defines T’s previous  action as an aligned response (line 7);

P displays a change in cognitive state and exaggerates it;
 

P completes her repair and deals with her error in a smiling voice.

P’s repetition expands the repair sequence and offers T the opportunity to intervene.
Transition Relevant Place (TRP)

 

 

T helps to expand the sequence by repeating P’s repair; he uses the same smiling tone as P’s first repair and adds a nuance of good humor/sympathy; he enables P to continue her story or expand the repair sequence further.

P tries unsuccessfully to hold back her laughter;

TRP


P aligns her intonation with T’s softer intonation (line 13); she now shows her awareness that her slip has major implications;

TRP

a generic concluding comment in a smiling tone again;


P repeats the correction in the flat tone she used for her storytelling before the repair and continues her story.

 

IMPLICIT / INTERSUBJECTIVITY

T intervenes displaying uncertainty and creates a potentially tense situation.

 

P hesitates

P misunderstands


P is now aware of her misunderstanding.


P displays appreciation that the lapsus has a funny side;

P appears to be emotionally upset and ashamed, perhaps thinking of the possible psychological implications of her lapsus; she expects T to intervene. The tension increases and affects the relationship (what is he thinking of me?)

T does not comment, and the tension starts to decrease



P can’t quickly retake control of her emotions

P is still expecting T intervene, but he avoids taking a turn
now both know that the other knows there is more to say.

 

T’s silence implies “now is not the time”.

Pia agrees “now is not the time”.
The tension is over

P again undertakes the role of storyteller and T the role of recipient.           

 

 

 

 

Recalling the Slip Episode

 

In the 7th session, the therapist takes an opportunity and recalls the Freudian slip episode. 

Excerpt 2 illustrates how it is dealt with and discussed five weeks later.

Excerpt 2 (session 7)

Pia is recounting that her father had been staying with her over the last week in order to help renovate her house. Pia emphasizes her husband’s good nature, as he puts up with his father-in-law’s criticism of everything he does, without taking offence. The therapist compares Pia’s husband to her brother, whom Pia also describes as “good natured” and accommodating with everyone, especially with his wife.

T: una volta lei li ha anche confusi se lo ricorda no?

T: you mixed the two up once, you do remember it, don’t you?
 

P: sì.

P: Yes.


T: io mi sono domandato che cosa voleva dire  (.) lei se l’è domandato

T: I asked myself what you meant (0.3); have you asked yourself

che cosa voleva dire (.)  perché li ha confusi
what you meant (0.3)? Why did you mix them up?

 

P: mio fratello e mio marito (1) probabilmente di fronte a questa

P: my brother and my husband (1.0) probably when faced with this

cosa:: forse perché: (1.5) lo considero talmente  buono che forse

thing :: maybe because :: (1.5) I consider him such a good person


sono io che ho gestito il rapporto:

that perhaps I’m the one who led the relationship:


lo guidavo

I guided him.

 

T   ecco perché io ho pensato- perché lei la volta successiva  (.) che

T: you see, because I thought – because the next time (0.2)

è venuta qui ha detto  (.) hm mi sono un po’ tirata indietro perché:: 

   you came here, you said hm: I held back a bit because::,

 

   con mio marito perché tutto sommato mi sembrava di avere  (0.3))

with my husband, because after all I thought I had (0.3)

premuto troppo a casa no?

pushed too hard at home, didn't you?                                                                            
 

P: hmm

P: hmm
(0.7)
     

P: sì anche perché hmm hmm io sto rivedendo molto  me stessa  nelle

P: yes, also because hmm hmm I’ve been thinking hard about my role

 

   relazioni  (.) prima di tutto   con mio marito

   in my relationships (0.3), especially with my husband

 

 

   però mi rendo conto che in fondo  (.) non mi piace farlo 

   but I realize that deep down (0.3) I don’t like doing it.

  ((parte del turno omesso))

  ((part of P’s turn omitted))

P: cioè fare questa parte da   dura che gestiva le cose

P: I mean, being this tough woman who runs things
 

Excerpt 2 provides evidence of their tacit mutual understanding in the fourth session: both thought that the 'Freudian slip' episode deserved further attention. Indeed, this excerpt shows not only that both remember the episode five weeks later, but more importantly that the therapist is confident that Pia remembers it as well ("You do remember it, don't you?"). Pia accepts the invitation – and this is the first time in the therapy – to be the first to elaborate and comment on her lapsus, taking a position that is peculiar to the therapist in these sessions (Bercelli et al., 2013). The therapist aligns with her by recalling a few words she said in a previous session, using direct speech. Reported direct speech displays and promotes affiliation (Holt & Clift, 2006).  Pia's past words insert smoothly into her present telling, and she goes on following and enhancing the same line of self-criticism ("I mean, being this tough woman that run things…….I realize that deep down I don't like doing it").

 Broadening the intersubjective field.

 

We define the Intersubjective field as the “mutual knowing of what is in the other’s mind, as it concerns the current nature and state of their relationship” (BCPSG, 2010: 7)

 In Excerpt 1, Pia ignores the chance she is offered to elaborate or comment on her lapsus, almost taking it for granted that it is the therapist’s role. However, five weeks later (Excerpt 2), she accepts talking about it first, and the therapist aligns. By aligning with her ponderings, the therapist validates also the position Pia takes within their relationship. It is not up to the therapist alone to comment, interpret, or suggest alternatives, nor is it Pia’s sole conversational role to agree, disagree, or discuss his comments, which is however common in this technique (Bercelli et al. 2008). Their roles can be reversed, and they are for the first time in this therapy. Being able to take more than one mutually validated position within a relationship may be considered a broadening of the intersubjective field, namely what each of them knows he or she has the mutually recognized right to do (Stern, 2004; BCPSG, 2010).

Moreover, it is also worth noting that the outcome of Pia’s pondering the lapsus is in tune with the modus operandi of the therapist, who proceeds by comparing and differentiating relationship positions rather than individual psychological traits, in a bid to produce changes within relationships outside of the sessions. 

 

 

 

 

Conclusions

The CA method provides a unitary framework to analyse both implicit and explicit level of interaction. What we analysed here is a three-steps therapeutic manoeuvre, where the first and the second steps are non-verbal actions.

1.     Breaking a pattern of expectation. The therapist restrains himself from commenting on the patient’s Freudian slip and her turmoil, as she is entitled to expect, according to a typical pattern in this context. Delving into the details of their interaction, we can identify the signs of their implicit mutual recognition that what happened was worth discussing, but that ‘this is not the time’. 

2.     A five-weeks gap. The therapist, and the patient as well, do not mention the slip episode in the next few sessions.

3.     Recalling the slip episode. The therapist takes a favourable occasion to ask Pia about the slip episode and its meaning. She explains the outcome of her ponderings about the issue, and the therapist aligns, changing their roles for the first time in this therapy. Such an exchange widens the intersubjective field (Stern, 2004; BCPSG, 2010)

The content of Pia’s answer and the therapist’s aligning as well provide evidence that Pia made a successful effort to understand the therapist’s way of thinking, as she read between the lines of his words and his silences, i.e., what they imply or hint at, but do not express – possibly as a response to similar efforts by the therapist. It is “this mutual effort to understand the intentionality and the state of mind of the other, that plays out in the co-creativity of therapy” (Mayes, 2005). 

It is most important here to underline that in regular clinical practise, therapists can accomplish such a three-step manoeuvre, apart from any detailed CA analysis. Sometimes, a significant event affecting the therapeutic relationship occurs during a session. Still, the therapist can feel it is inappropriate commenting or discussing with the patient what has just happened and prefers to hold off. In the next few sessions, he/she will wait for the right opportunity to recall that event and check if the memories and reflections by the patient fit his own. In successful therapies, the patients often manage to grasp the therapist’s way of thinking and processing through their overall modus operandi, not necessarily translated into an explicit verbal mode. It is not unusual that the patients say something that the therapist has thought but not said (Semerari, 1991).

Such a contingency provides evidence of an intersubjective understanding.

 

Appendix: Transciption symbols

 

 

(0.2)                                                                     timed pause

word [word]                                     overlapped words

           [word]

(word)                                                 uncertain word

wor-                                                     sharp cut-off (glottal stop)

wo:rd                                                    : indicates stretching of the preceding sound. The more colons, the longer the stretching

£word£                                                               smiley voice

°word°                                                 quiet, soft voice

word                                                    underlining indicates some form of stress or emphasis

WORD                                  louder voice

h                                                            audible espiration  

.h                                                           audible inspiration

↑                                                          upward intonation

↓                                                          downward intonation

(h)e(h)e()   w(h)or(h)d                laughing

((cough))                                            sounds impossible to write phonetically

, . ?                                                         comma denotes a falling intonation; period a terminal intonation; interrogation mark a rising intonation (more than ↑)

 

 

 

 

 

 

 

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