Abstract
This study is part of a larger exploration of ‘talk and cure’ that combines the examination of talk-in-interaction with nonverbal displays and measurements of the client’s and therapist’s autonomic arousal during therapy sessions. A key assumption of the study is that psychotherapy entails processes of intersubjective meaning-making that occur across different modalities and take place in both verbal/explicit and nonverbal/implicit domains. A single session of a psychodynamic psychotherapy is analyzed with a focus on the expression and management of affect, with an aim to describe key interactive events that promote change in both semantic and procedural domains. The clinical dialog is analyzed discursively, with a focus on the conversational processes through which new meanings are jointly constructed and affective states shared; detailed attention is paid to nonverbal displays of affiliation and affect. Furthermore, we explore whether the interactional patterns implicated in joint meaning-making, as revealed by analyzing the therapeutic conversation, have correlates in the autonomic arousal of the two protagonists, as reflected in their heart rates. Conversation analysis has still untapped potential to illuminate interactional patterns that underlie the practice of psychotherapy. In this exploratory study we suggest that discursive analyses of talk-in-interaction can be enriched through detailed focus on nonverbal displays as well as measures of physiological arousal. Drawing upon the analysis, we suggest that bringing the methodological strengths of language-based analysis into fertile dialog with embodied quantitative data can help our explorations of what’s really going on in psychotherapy.
Highlights
There is a proliferation of theories of psychotherapy, there is relatively little in-session research that explores in detail the processes through which change takes place as a session unfolds
We initially present a simple description of the trajectory of autonomic arousal through the session for both participants, followed by analysis of the session in terms of conversation and nonverbal interaction
This study aimed to combine a detailed description of one session of psychodynamic therapy through the analytic tools provided by conversation analysis, whilst paying close attention to nonverbal interaction, with insights gained from examining the trajectory of autonomic arousal of participants through the session
Summary
There is a proliferation of theories of psychotherapy, there is relatively little in-session research that explores in detail the processes through which change takes place as a session unfolds In this exploratory single-case study, we examine in detail, and from different perspectives, one session of psychoanalytic face-to-face psychotherapy with an aim to describe therapeutic interaction on both explicit/conscious/verbal and implicit procedural levels (Stern et al, 1998). We approach psychotherapy as a relational process of intersubjective meaning-making; that is, a process through which client(s) and therapist jointly construct meaning, through multiple modalities of communication Psychotherapy in this sense relies on a particular kind of conversation in a relational context that fosters the reconstruction of meaning and the reformulation of the client’s subjectivity (e.g., Avdi and Georgaca, 2018). Since its inception as the ‘talking cure’, language and meaning have been considered fundamental aspects of psychotherapy, and several discursive and conversation analytic (CA) studies have described different elements of the processes implicated in meaning construction in therapy (for reviews see Avdi and Georgaca, 2007; Peräkylä et al, 2008; Smoliak and Strong, 2018)
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