Abstract
Concealment, an act of intentionally withholding information for some purposes, is considered to be often employed by caregivers to veil the terminal status of the patients. This paper therefore investigates the pragmatics of concealment in interactions between terminally-ill patients and their caregivers as it relates to psychotherapeutic process; thereby complementing existing studies which have largely captured attitudes, strategies and structures of such discourses. Seven interactions, capturing cancer, heart disease and kidney failure, were collected through tape-recording and participants’ observation at University College Hospital, Ibadan, between February and August, 2016. These were transcribed and analysed using convergence aspect of Gile’s Communication Accommodation Theory. Findings show that concealment in this discourse pragmatically configures psychotherapeutic context which bifurcates into palliative psychotherapy and cognitive-behavioural therapy. Palliative psychotherapy, through shared situational knowledge and mutual contextual belief, raises hope of recovery and dislodges fear of death. Cognitive-behavioural therapy, through shared cultural knowledge, facilitates compliance and support in the healing process. The aforementioned findings resonate that the use of concealment in therapeutic discourse psychologically changes the underlying thoughts that contribute to mental depression and modifies the problematic behaviours that result from these thoughts
Highlights
Concealment, an act of intentionally withholding information for some purposes, has been explored as a discourse strategy in medical discourse
A doctor went to the hospital ward to meet a patient of acute renal failure, who appeared to be wealthy based on the kind of care that his family members gave him in the hospital
Patient: @ I trust them; they cannot do that ↑ Using both non-linguistic and linguistic (Sir, when you recover and get home, your children will be making a mockery of you because you feel uncomfortable taking injections), the nurse is able to instill a level of psychological relief into the patient because the duo have the shared situational knowledge (SSK) and mutual contextual belief (MCB) that in this part of the world, patient who does not adequately cooperate with the healing process by feeling uncomfortable is usually mocked after recovery
Summary
Concealment, an act of intentionally withholding information for some purposes, has been explored as a discourse strategy in medical discourse. 4. Patient: @ I trust them; they cannot do that ↑ Using both non-linguistic (putting on a smiling face and holding the patient‟s hand) and linguistic (Sir, when you recover and get home, your children will be making a mockery of you because you feel uncomfortable taking injections), the nurse is able to instill a level of psychological relief into the patient because the duo have the shared situational knowledge (SSK) and mutual contextual belief (MCB) that in this part of the world, patient who does not adequately cooperate with the healing process by feeling uncomfortable is usually mocked after recovery.
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